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L’Organisation mondiale de la santé met à jour sa classification de l’autisme dans la CIM-11

nouvelle Classification internationale des maladies (CIM-11). La CIM répertorie différentes pathologies et conditions afin de fournir un langage commun pour informer et contrôler leur développement, ainsi que de comparer et de partager des données selon des critères standardisés entre les hôpitaux, les régions et les pays à différentes périodes. Pour ce faire, les termes de diagnostic sont convertis en environ 55 000 codes alphanumériques uniques.

La CIM-11 est le résultat de dix années de travail et remplace la classification précédente, publiée il y a 28 ans, dans le but d’offrir une vue actualisée des différentes conditions de santé et de maladie. Il y a eu une implication sans précédent des professionnels dans  le domaine de la santé lors de l’élaboration de cette 11ème édition de la CIM. Ils ont participé à des réunions de collaboration et soumis des propositions. L’équipe de la CIM au siège de l’OMS a reçu plus de 10 000 propositions de révisions. La CIM-11 sera présentée à l’Assemblée mondiale de la Santé en mai 2019 pour adoption par les États membres et entrera en vigueur le 1er janvier 2022.

Qu’est-ce qui a changé dans la classification de l’autisme par la CIM?

La CIM-11 met à jour les critères de diagnostic de l’autisme, et est maintenant plus en ligne avec le DSM-5 (Manuel diagnostique et statistique des troubles mentaux) publié en 2013 par l’American Psychiatric Association. C’est-à-dire qu’il inclut le syndrome d’Asperger, le trouble désintégratif de l’enfance et certains autres troubles du développement généralisés, dans la catégorie «Autisme».

En ce qui concerne les descriptions des caractéristiques de l’autisme, la CIM-11 comprend également les deux mêmes catégories que le DSM-5, c’est-à-dire les difficultés d’interaction et de communication sociale d’une part, et les intérêts restreints et les comportements répétitifs de l’autre. Il supprime ainsi une troisième caractéristique énumérée dans la précédente édition de la CIM, liée aux problèmes de langage. Les deux classifications soulignent également l’importance d’examiner les sensibilités sensorielles inhabituelles, ce qui est fréquent chez les personnes autistes.

Cependant, la CIM-11 et le DSM-5 divergent de plusieurs façons. Par exemple, la classification de la CIM-11 fournit des lignes directrices détaillées pour faire la distinction entre l’autisme avec et sans handicap intellectuel. Le DSM-5, pour sa part, déclare seulement que l’autisme et le handicap intellectuel peuvent être simultanés. La CIM-11 inclut également la perte des compétences acquises précédemment comme caractéristique à prendre en compte lors du diagnostic.

En ce qui concerne l’autisme pendant l’enfance, la CIM-11 insiste moins sur le type de jeu auquel les enfants participent, puisque cela peut varier selon le pays ou la culture. Elle se concentre plutôt sur le fait que les enfants suivent ou imposent des règles strictes lorsqu’ils jouent, un comportement qui peut être perçu dans n’importe quelle culture et qui peut être un signe d’inflexibilité dans la pensée, une caractéristique commune chez les personnes autistes.

Pour plus d’informations sur la CIM-11

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