The latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) included the Social (Pragmatic) Communication Disorder (SPCD) as a new mental disorder characterized by deficits in pragmatic abilities. Although the introduction of SPCD in the psychiatry nosography depended on a variety of reasons—including bridging a nosological gap in the macro-category of Communication Disorders—in the last few years researchers have identified major issues in such revision. For instance, the symptomatology of SPCD is notably close to that of (some forms of) Autism Spectrum Disorder (ASD). This opens up the possibility that individuals with very similar symptoms can be diagnosed differently (with either ASD or SPCD) and receive different clinical treatments and social support. The aim of this paper is to review recent debates on SPCD, particularly as regards its independence from ASD. In the first part, we outline the major aspects of the DSM-5 nosological revision involving ASD and SPCD. In the second part, we focus on the validity and reliability of SPCD. First, we analyze literature on three potential validators of SPCD, i.e., etiology, response to treatment, and measurability. Then, we turn to reliability issues connected with the introduction of the grandfather clause and the use of the concepts of spectrum and threshold in the definition of ASD. In the conclusion, we evaluate whether SPCD could play any role in contemporary psychiatry other than that of an independent mental disorder and discuss the role that non-epistemic factors could play in the delineation of the future psychiatry nosography.

最新版精神障碍诊断与统计手册（DSM-5）将社交（语用）沟通障碍（SPCD）纳入为一种以语用能力缺陷为特征的新型精神障碍。尽管在精神病学分类学中引入 SPCD 取决于多种原因，包括弥合沟通障碍宏观类别中的分类学差距，但在过去几年中，研究人员已经确定了此类修订中的主要问题。例如，SPCD 的症状与（某些形式的）自闭症谱系障碍 (ASD) 的症状非常接近。这使得具有非常相似症状的个体可以被不同地诊断（ASD 或 SPCD）并接受不同的临床治疗和社会支持。本文的目的是回顾最近关于 SPCD 的争论，特别是关于其独立于 ASD 的争论。在第一部分中，我们概述了 DSM-5 疾病分类学修订涉及 ASD 和 SPCD 的主要方面。第二部分重点关注SPCD的有效性和信度。首先，我们分析了有关 SPCD 三个潜在验证因素的文献，即病因学、治疗反应和可测量性。然后，我们转向与祖父条款的引入以及 ASD 定义中频谱和阈值概念的使用相关的可靠性问题。在结论中，我们评估了 SPCD 是否可以在当代精神病学中发挥除独立精神障碍之外的任何作用，并讨论非认知因素在描绘未来精神病学分类学中可能发挥的作用。