Kate Middleton Is Pregnant, in Hospital

Kate Middleton is pregnant.

The most eagerly awaited pregnancy was announced today by St. James Palace on behalf of Middleton and her husband Prince William.

The child, whether boy or girl, will eventually be heir to the British throne according to new legislation awaiting final approval.

The duchess was admitted to King Edward VII Hospital today in central London with hyperemesis gravidarum, an acute morning sickness which requires supplementary hydration and nutrients, the palace said.

Prince William is by his wife's side at the hospital, according to Britain's Press Association.

Click here for photos of Kate through the years.

"As the pregnancy is in its very early stages, Her Royal Highness is expected to stay in hospital for several days and will require a period of rest thereafter," the statement said.

The royal family was clearly delighted with the news.

"Their Royal Highnesses The Duke and Duchess of Cambridge are very pleased to announce that The Duchess of Cambridge is expecting a baby," the palace said in a statement today. "The Queen, The Duke of Edinburgh, The Prince of Wales, The Duchess of Cornwall and Prince Harry and members of both families are delighted with the news."

British Prime Minister David Cameron also reacted to the big news, telling BBC, "It's absolutely wonderful news and I'm sure everyone around the country will be celebrating with them tonight."

The prime minister told BBC that he found out when "I was handed a note in a meeting. And I have to say, it was difficult to keep it a secret."

The baby will be the queen's third great-grandchild.

Jonathan Nackstrand/AFP/Getty Images

Kate Middleton Pregnant, Admitted to Hospital Watch Video

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Robert Lacey, author of the definitive book "Majesty" said, "The British public and indeed the whole world will be delighted for the same, it keeps the monarchy going. The royal wedding brought a magic back to the monarchy and people are fascinated by William and Catherine."

The announcement follows relentless public and media speculation about when Prince William and his wife would have an heir. The guessing game began almost immediately after the couple said, "I do."

Click here for an interactive look at William and Kate's love story.

Tabloids began snapping close-ups of Middleton's stomach for any indication of a baby bump. Baby rumors abounded when the duchess held a baby at a press event and when she declined peanut butter at another event. British physicians are known to warn women against eating peanuts during pregnancy. When the couple got a dog, Lupo, headlines wondered if they were practicing for another addition to the family.

Click here for more on royal heirs around the world.

The palace, which rarely comments on speculation, took the unusual step of saying, "We would be the ones to make the announcement, not Hollywood."

"It is quite strange reading about it, but I try not to let it bother me," Prince William said in an interview with ABC News' Katie Couric in May 2012. "I'm just very keen to have a family and both Catherine and I are looking forward to having a family in the future."

Asked by Couric if there was anything else he wanted to share, he coyly answered, "You won't get anything out of me. Tight lipped."

Due to a dramatic change in the rules of succession, the royal couple's first-born will likely be the heir to the throne, regardless of the baby's gender.

Last year, the heads of 16 Commonwealth countries agreed to a change in the rules of succession so that first-born children of either gender can take the throne. Queen Elizabeth II was only eligible to be monarch because her father had no male children. The British Parliament must still amend existing law to make the succession change official.

"Put simply, if the Duke and Duchess of Cambridge were to have a little girl, that girl would one day be our queen," British Prime Minister David Cameron told reporters in 2011.

Royal babies have typically been born within one year of marriage. Princess Diana gave birth to William just 11 months after her wedding and the queen gave birth to Prince Charles six days before her first wedding anniversary.

Prince William and Kate were married on April 29, 2011.

William, who has long been known for making privacy a priority, will now be faced with the inevitable fascination with his first child. And the scrutiny will doubtless be familiar to him.

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Israel says will stick with settlement plan despite European pressure

JERUSALEM (Reuters) - Israel rejected concerted criticism from Europe on Monday over Prime Minister Benjamin Netanyahu's decision to expand settlement building after the United Nations' de facto recognition of Palestinian statehood.

Britain, France, Spain, Sweden and Denmark summoned the Israeli ambassadors in their capitals to hear appeals for Netanyahu to reverse course and deep disapproval of the plan to erect 3,000 more homes in the occupied West Bank and East Jerusalem.

An official in Netanyahu's office said Israel would not bend. "Israel will continue to stand by its vital interests, even in the face of international pressure, and there will be no change in the decision that was made," the official said.

Angered by the U.N. General Assembly's upgrading on Thursday of the Palestinians' status in the world body from "observer entity" to "non-member state", Israel said the next day it would build the new dwellings for settlers.

Such projects, on land Israel captured in a 1967 war, have routinely drawn world condemnation. Approximately 500,000 Israelis and 2.5 million Palestinians live in the two areas.

In a shift that raised the alarm among Palestinians and in world capitals, Netanyahu's pro-settler government also ordered "preliminary zoning and planning work" for thousands of housing units in areas including the "E1" zone east of Jerusalem.

Such construction in the barren hills of E1 has never been put into motion in the face of opposition from Israel's main ally, the United States. Building in the area could bisect the West Bank, cut off Palestinians from Jerusalem and further dim their hopes for a contiguous state.

The settlement plan, U.N. Secretary-General Ban Ki-moon said, would deal "an almost fatal blow" to a two-state solution to the Israeli-Palestinian conflict.

"We don't want to shift into sanctions mode," French President Francois Hollande told a news conference with Italian Prime Minister Mario Monti. "We are more focused on persuading."

Britain made clear it would not back such Israeli retaliation over the U.N. vote, which Palestinians sought after peace talks collapsed in 2010 over settlement building.

"We deplore the recent Israeli decision to build 3,000 new housing units and unfreeze development in the E1 block," a Foreign Office spokesman said. "We have called on the Israeli government to reverse the decision."

But a spokesman for British Prime Minister David Cameron played down what diplomatic sources said was the possibility of recalling Britain's ambassador in Tel Aviv, saying: "We are not proposing to do anything further at this stage".

France expressed "serious concerns" to the Israeli ambassador, reminding him that settlement building in occupied territories was illegal and an "obstacle" to reviving peace talks with the Palestinians.

A French Foreign Ministry official, responding to reports Paris might bring its Tel Aviv envoy home, said: "There are other ways in which we can express our disapproval."

Ahead of a Netanyahu visit this week, Germany, considered Israel's closest ally in Europe, urged it to refrain from expanding settlements, and Russia said it viewed the Israeli moves with serious concern.

RETALIATION

Israeli Finance Minister Yuval Steinitz said Israel could not have remained indifferent to the Palestinians' unilateral move at the United Nations.

"I want to tell you that those same Europeans and Americans who are now telling us 'naughty, naughty' over our response, understand full-well that we have to respond, and they themselves warned the Palestinian Authority," he said.

Palestinian chief negotiator Saeb Erekat said building in E1 "destroys the two-state solution, (establishing) East Jerusalem as the capital of Palestine and practically ends the peace process and any opportunity to talk about negotiations in the future".

The United States, one of the eight countries to vote alongside Israel against the Palestinian resolution at the General Assembly, has said the settlement plan was counterproductive to the resumption of direct peace talks.

Washington used the same argument in opposing the Palestinian initiative at the United Nations.

In Europe, only the Czech Republic voted against the status upgrade while many countries, including France, backed it. Netanyahu plans to visit Prague this week to express his thanks.

In the Gaza Strip, Sami Abu Zuhri, spokesman for the governing Hamas Islamist movement, called Israeli settlement "an insult to the international community, which should bear responsibility for Israeli violations and attacks on Palestinians".

In another blow to the Palestinian Authority, which exercises limited self-rule in the West Bank, Israel announced on Sunday it was withholding Palestinian tax revenues this month worth about $100 million, arguing the Palestinians owed $200 million to Israeli companies.

"These are not steps towards peace, these are steps towards the extension of the conflict," Spanish Foreign Minister Jose Manuel Garcia-Margallo said.

Only three weeks ago, Netanyahu won strong European and U.S. support for a Gaza offensive that Israel said was aimed at curbing persistent cross-border rocket fire.

Favored by opinion polls to win a January 22 national election, he brushed off the condemnation and complaints at home that he is deepening Israel's diplomatic isolation.

Netanyahu told his cabinet on Sunday that his government "will carry on building in Jerusalem and in all the places on the map of Israel's strategic interests".

But while his housing minister has said the government would soon invite bids from contractors to build 1,000 homes for Israelis in East Jerusalem and more than 1,000 in West Bank settlement blocs, the E1 plan is still in its planning stages.

"No one will build until it is clear what will be done there," the minister, Ariel Attias, said on Sunday.

Israel froze much of its activities in E1 under pressure from former U.S. President George W. Bush, and the area has been under the scrutiny of his successor, Barack Obama.

Most world powers consider Israel's settlements to be illegal. Israel cites historical and Biblical links to the West Bank and Jerusalem and regards all of the holy city as its capital, a claim that is not recognized internationally.

(Additional reporting by Crispian Balmer, Dan Williams, Nidal al-Mughrabi in Gaza, Jihan Abdalla in Ramallah, Steve Gutterman in Moscow, Gareth Jones in Berlin, John Irish and Elizabeth Pineau in Paris and Tim Castle in London; writing by Jeffrey Heller; editing by Philippa Fletcher)

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Top accounting firms face charges over China data

WASHINGTON: US market regulators charged the China affiliates of five top accounting firms Monday with violation of securities laws for refusing to provide audit data related to China-based companies.

"The audit materials are being sought as part of SEC investigations into potential wrongdoing by nine China-based companies whose securities are publicly traded in the US," the Securities and Exchange Commission said.

The five firms charged were BDO China Dahua, Deloitte Touche Tohmatsu Certified Public Accountants, Ernst & Young Hua Ming, KPMG Huazhen, and PricewaterhouseCoopers Zhong Tian.

The SEC said they violated the Securities Exchange Act and the Sarbanes-Oxley Act, which requires foreign public accounting firms to provide the SEC upon request with audit work papers involving any company trading on US markets.

SEC investigators have been trying to obtain the data for months from the audit firms but they have refused to cooperate, it said in a statement.

"Only with access to work papers of foreign public accounting firms can the SEC test the quality of the underlying audits and protect investors from the dangers of accounting fraud," said Robert Khuzami, director of the SEC's Division of Enforcement.

"Firms that conduct audits knowing they cannot comply with laws requiring access to these work papers face serious sanctions."

- AFP/fa

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NRHM scam: CBI files chargesheet against Pradeep Shukla

GHAZIABAD: The CBI today filed chargesheet against senior IAS officer Pradeep Shukla in connection with alleged irregularities in upgrading of 89 district hospitals in the state, under National Rural Health Mission scheme, causing a loss of Rs 16 crore to the exchequer.

The agency had received sanction to prosecute Shukla, the then family welfare secretary, on November 30 from the Centre after that a chargesheet was filed before special CBI court today.

Shukla and officials of UP Processing and Construction Cooperative Federation Ltd (PACCFED), including its managing director V K Chowdhary, the then DG of family welfare S P Ram, Moradabad-based businessman Saurabh Jain, and his firms were booked by the agency in January this year.

While remaining accused were chargesheeted in May this year, the charge sheet against Shukla was pending because CBI was awaiting sanction for his prosecution.

The 55-year-old UP-cadre IAS officer, serving as member revenue board, was arrested by the agency in May but was released on bail.

After release, Shukla joined back as member revenue board but the UP government issued orders of him being "deemed suspended".

CBI alleged officials of PACCFED favoured ineligible firms and released payment of Rs 16.93 crore on the basis of forged documents.

In its chargesheet, the agency alleged Shukla along with Ram entered in criminal conspiracy with private firms and gave contract related to upgrading of district hospitals in Uttar Pradesh worth Rs 89 crore on the basis of forged documents.

Out of Rs 16 crore loss caused to exchequer, more than Rs 13 crore was allegedly cornered by Jain, close confidante of former family welfare minister Babu Singh Kushwaha, who used it to bribe public servants and also invested in various companies.

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Explainer: Why was pregnant duchess hospitalized?

LONDON (AP) — While morning sickness in pregnant women is common, the problem the Duchess of Cambridge has been hospitalized with is not.

In a statement Monday, palace officials said she was hospitalized with hyperemesis gravidarum, a potentially dangerous type of morning sickness where vomiting is so severe no food or liquid can be kept down. Palace officials said the duchess was expected to remain hospitalized for several days and would require a period of rest afterwards.

"It's not unusual for pregnant women to get morning sickness, but when it gets to the point where you're dehydrated, losing weight or vomiting so much you begin to build up (toxic) products in your blood, that's a concern," said Dr. Kecia Gaither, director of maternal fetal medicine at Brookdale University and Medical Center in New York.

The condition is thought to affect about one in 50 pregnant women and tends to be more common in young women, women who are pregnant for the first time, those expecting multiple babies and in non-smokers. Gaither said that fewer than one percent of women with the condition need to be hospitalized.

Doctors aren't sure what causes it but suspect it could be linked to hormonal changes or nutritional problems.

Women admitted to the hospital with hyperemesis gravidarum are usually treated with nutritional supplements and given fluids intravenously to treat dehydration. Dr. Dagni Rajasingam, a spokeswoman for the Royal College of Obstetricians and Gynaecologists, said most women hospitalized with the condition are discharged within several days.

"It depends on how well the woman is keeping fluids down," she said.

If the problem is recognized and treated early, doctors say there are no long-term effects for either the mother or the child. Left untreated, the mother could be at risk of developing neurological problems — including seizures — or risk delivering the baby early.

Gaither said the condition usually subsides by the second trimester.

"The rest of the pregnancy could be entirely uneventful," she said, adding that pregnant women treated for the condition are usually advised to avoid fatty foods that could aggravate the problem.

Gaither said the duchess would probably be able to meet her usual royal obligations by her second trimester.

"She should be able to meet all her public obligations soon," she said, advising her to take her vitamins and ensure there are no other underlying health problems. "She should just be looking forward to having a healthy little plump person."

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Geithner on Fiscal Cliff: Ball Is in GOP's Court

(ABC News)

With the fiscal cliff looming and no deal to resolve it in sight, Treasury Secretary Timothy Geithner expressed confidence that a compromise could be reached during my interview with him on “This Week,” but said the burden is now on Republicans to help find a solution to avoid a potential economic crisis.

(More from Sunday’s show HERE.)

“I actually think that we’re gonna get there. I mean, you know, just inevitably gonna be a little political theater in this context,” Geithner said, when asked whether Senate Minority Leader Mitch McConnell laughed after hearing President Obama’s plan to avert the fiscal cliff. ”Sometimes that’s a sign of progress. Think we’re actually making a little bit of progress, but we’re still some distance apart.”

Echoing widespread Republican rejection of the White House’s proposal last week, House Speaker John Boehner said after meeting with Geithner that ” the White House has to get serious.”

“And at this point though — you gotta recognize that they’re in a very difficult place. And they recognize they’re gonna have to move on a bunch of things.  But they don’t know really how to do it yet. And how to get support from the — from the members on the Republican side,” he said, adding later that the proverbial ball was “absolutely” in the GOP court. “And, you know, when they come back to us and say, ‘We’d like you to consider this.  And we’d like you to consider that,’ we’ll take a look at that.”

Geithner — who met with top GOP leaders this week to present the White House’s proposal to end the fiscal standoff — predicted support from “the business community” and “from the American people” for a deal approximating the one being offered, which reportedly includes tax hikes on the wealthy, cuts to Medicare and some stimulus spending.

However, if there is no agreement by the end of the year, the treasury secretary told me going over the cliff would be “very damaging.”

“Look, there’s a huge amount at stake here in this economy, George.  And there’s just no reason why 98 percent of Americans have to see their taxes go up because some members of Congress on the Republican side want to block tax rate increases for 2 percent of the wealthiest Americans.  Remember, those tax rates, those tax cuts, cost a trillion dollars over 10 years,” he said.

Geithner said the White House plan offered a “good mix” of increased taxes and spending cuts. He also added that Social Security reform would not be part of the discussion to resolve the fiscal cliff.

“We think we have a very good plan, a very good mix of tax reforms that raise a modest amount of revenue on the wealthiest 2 percent of Americans, combined with very comprehensive, very well designed, very detailed savings that get us back to the point where our debt is stable and sustainable,” he said. “We’re prepared to, in a separate process, look at how to strengthen Social Security.  But not as part of a process to reduce the other deficits the country faces,” he said.

Finally, with Geithner wrapping up his time in the president’s cabinet, I asked him if banking executive Jamie Dimon – who has  billionaire Warren Buffett’s endorsement — should be named the next treasury secretary, but Geithner declined to answer directly.

“George, the president’s gonna choose somebody very talented to lead the Treasury for his next four years.  And– I’m very fortunate I’ve been able to work with him to help solve these problems in the country over this period of time.  And I’m very confident he’s gonna have somebody in place– in January to succeed me,” he said.

Like “This Week” on Facebook here. You can also follow the show on Twitter here.

Get more pure politics at ABC News.com/Politics and a lighter take on the news at OTUSNews.com

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Islamist protest shuts down Egypt's top court

CAIRO (Reuters) - Protests by Islamists allied to President Mohamed Mursi forced Egypt's highest court to adjourn its work indefinitely on Sunday, intensifying a conflict between some of the country's top judges and the head of state.

The Supreme Constitutional Court said it would not convene until its judges could operate without "psychological and material pressure", saying protesters had stopped the judges from reaching the building.

Several hundred Mursi supporters had protested outside the court through the night ahead of a session expected to examine the legality of parliament's upper house and the assembly that drafted a new constitution, both of them Islamist-controlled.

The cases have cast a legal shadow over Mursi's efforts to chart a way out of a crisis ignited by a November 22 decree that temporarily expanded his powers and led to nationwide protests.

The court's decision to suspend its activities appeared unlikely to have any immediate impact on Mursi's drive to get the new constitution passed in a national referendum on December 15.

Three people have been killed and hundreds wounded in protests and counter-demonstrations over Mursi's decree.

At least 200,000 of Mursi's supporters attended a rally at Cairo University on Saturday. His opponents are staging an open-ended sit-in in Cairo's Tahrir Square, the cradle of the uprising that toppled Hosni Mubarak in February 2011.

Mursi and the Muslim Brotherhood, which propelled him to power in a June election, hope to end the crisis by pushing through the new constitution hastily adopted by the drafting assembly on Friday. The next day the assembly handed the text to Mursi, who called the referendum and urged Egyptians to vote.

"The Muslim Brotherhood is determined to go ahead with its own plans regardless of everybody else. There is no compromise on the horizon," said Hassan Nafaa, a professor of political science at Cairo University.

Outside the Supreme Constitutional Court, Muslim Brotherhood supporters rallied behind the referendum date. "Yes to the constitution", declared a banner held aloft by one protester. Chants demanded the "purging of the judiciary".

The interior minister told the head of the court that the building was accessible and the protests were peaceful, according a statement from the ministry.

The protest reflected the deep suspicion harbored by Egypt's Islamists towards a court they see as a vestige of the Mubarak era. The same court ruled in June to dissolve the Muslim Brotherhood-led lower house of parliament.

Since then, several legal cases have challenged the legitimacy of the upper house of parliament and the 100-member constituent assembly that wrote the constitution.

Those against the upper house have focused on the legality of the law by which it was elected, while the constitutional assembly has faced a raft of court cases alleging that the way it was picked was illegal.

STOCK MARKET RALLIES

Mursi believes that securing approval for the new constitution in a popular referendum will bury all arguments on the legality of the constituent assembly, as well as controversy over the text it worked through the night to finish on Friday.

It will also override the November 22 decree that prompted statements of concern from Western governments and a rebellion by sections of the judiciary that saw it as a threat to their role. The decree shielded Mursi from judicial oversight.

Judges supervise voting in Egypt, so Mursi now needs them to oversee the referendum. Vice President Mahmoud Mekky said on Sunday he was confident the judges would perform that role, though Mursi's critics in the judiciary may call for a boycott.

While the Islamists' critics, including representatives of the Christian minority, have accused the Brotherhood of trying to hijack the constitution, investors appear to have seen Mursi's moves as a harbinger of stability. They were also relieved that Saturday's mass Islamist protest went off calmly.

The main stock market index, which lost a tenth of its value in response to Mursi's November 22 decree, rallied more than 2 percent when the market opened on Sunday.

"The events that took place through the weekend, from the approval of the final draft of the constitution and the president calling a referendum, gave some confidence to investors that political stability is on track," said Mohamed Radwan of Pharos Securities, an Egyptian brokerage.

But the political opposition, made up of leftist, liberal and socialist parties, have been infuriated by what they see as the Brotherhood's attempt to ram through a constitution that does not enjoy national consensus.

Mursi's opponents warn of deeper polarization ahead.

"LET EVERYONE HAVE THEIR SAY"

Leading opposition figure Mohamed ElBaradei said on Twitter that the "struggle will continue" over a draft constitution that "undermines basic freedoms".

Liberal figures, including former Arab League chief Amr Moussa, pulled out of the constituent assembly last month, as did Christian representatives.

The draft constitution contains Islamist-flavored language which opponents say could be used to whittle away human rights and stifle criticism. It forbids blasphemy and "insults to any person", does not explicitly uphold women's rights and demands respect for "religion, traditions and family values".

The New York-based Human Rights Watch said it protected some rights while undermining others.

The text limits presidents to two four-year terms, requires parliamentary approval for their choice of prime minister, and introduces some civilian oversight of the military - although not enough for critics. Mubarak ruled for three decades.

Mursi described it as a constitution that fulfilled the goals of the January 25, 2011 revolution that ended Mubarak's rule. "Let everyone - those who agree and those who disagree - go to the referendum to have their say," he said.

The Islamists are gambling that they will be able to secure a "yes" vote by mobilizing their core support base and many other Egyptians keen for an end to two years of turmoil that has taken a heavy toll on the economy.

Nafaa of Cairo University said the constitution would likely be approved by a slim majority. "But in this case, how can you run a country with a disputed constitution - a constitution not adopted by consensus?" he asked.

(Writing by Tom Perry; Editing by Alistair Lyon)

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Footbal: Barton stars as Marseille beat Brest

PARIS: Joey Barton was at the centre of both goals as Marseille bounced back from their crushing midweek defeat to Lyon by meting out a 2-1 win to Brest on Sunday.

Elie Baup's men, swept aside 4-1 by Lyon on Wednesday, were back in business inflicting a first home loss of the season on Brest to move up two places into second on 29 points, two behind their midweek tormentors.

Souleymane Diawara put Marseille into a 34th minute lead.

Set up by Barton, the Senegal defender, largely absent in Wednesday's game, broke the deadlock when firing the ball under the crossbar from the edge of the box.

Brest were back on level terms three minutes from the break, with close season signing Dutch striker Charlison Benschop wrong footing Marseille keeper Steve Mandanda off a corner.

The second half was 11 minutes old when Marseille regained the advantage.

Once again, Barton was key. The English midfielder picking up Mathieu Valbuena's cross to feed Andre Ayew who poked the ball home past Brest keeper Alexis Thebaux.

Marseille, who dominated most of the game, deservedly held on for a welcome three points.

This was a bright ending to an uncomfortable week for Marseille, some of whose fans were critical of club president Vincent Labrune for openly laughing during their team's defeat to Lyon on images shown on French television.

Troyes host Rennes and Toulouse are at Lorient in sunday's two late games.

On Saturday, Lyon underlined their title credentials as they beat defending champions Montpellier 1-0, while chasing Paris Saint-Germain slumped to a 2-1 defeat at Nice.

- AFP/fa

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FDI in retail to safeguard international market mafias' interest: BJP

ANI Dec 1, 2012, 03.28PM IST

NEW DELHI: India's main opposition Bharatiya Janata Party (BJP) today said retail reform is a step taken by the Congress led-federal government to safeguard the interests of the international market mafias at the cost of national interest.

BJP vice president Mukhtar Abbas Naqvi said on Saturday that voting inside the parliament would decide as to who is in favour of national interest and who is working for international interests.

"The government feels that their responsibility is to safeguard the interest of international market mafias instead of national interest and for saving the interest of international market mafias, the government is ready to compromise with national interests. Now, the parliament will decide as to who is in support of international market mafias and who are supporting national interests," said Naqvi.

The government's decision to allow foreign supermarket chains such as Wal-Mart had triggered protest not only from opposition parties but also from some of its allies.

BJP had sought debate on the issue of allowing Foreign Direct Investment (FDI) in the retail sector, under the rule that entails voting after discussions.

Meanwhile, Minister in the Prime Minister Office (PMO), V Narayanaswamy said the government would answer all the queries raised by the opposition parties in the parliament and will explain the benefits of allowing FDI in retail sector.

The lower house of parliament has set December 04 and 05 as the date to vote and debate on FDI. The dates for the upper house are yet to be decided.

Narayanaswamy said the government is confident of becoming victorious in the debate.

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Asperger's dropped from revised diagnosis manual

CHICAGO (AP) — The now familiar term "Asperger's disorder" is being dropped. And abnormally bad and frequent temper tantrums will be given a scientific-sounding diagnosis called DMDD. But "dyslexia" and other learning disorders remain.

The revisions come in the first major rewrite in nearly 20 years of the diagnostic guide used by the nation's psychiatrists. Changes were approved Saturday.

Full details of all the revisions will come next May when the American Psychiatric Association's new diagnostic manual is published, but the impact will be huge, affecting millions of children and adults worldwide. The manual also is important for the insurance industry in deciding what treatment to pay for, and it helps schools decide how to allot special education.

This diagnostic guide "defines what constellations of symptoms" doctors recognize as mental disorders, said Dr. Mark Olfson, a Columbia University psychiatry professor. More important, he said, it "shapes who will receive what treatment. Even seemingly subtle changes to the criteria can have substantial effects on patterns of care."

Olfson was not involved in the revision process. The changes were approved Saturday in suburban Washington, D.C., by the psychiatric association's board of trustees.

The aim is not to expand the number of people diagnosed with mental illness, but to ensure that affected children and adults are more accurately diagnosed so they can get the most appropriate treatment, said Dr. David Kupfer. He chaired the task force in charge of revising the manual and is a psychiatry professor at the University of Pittsburgh.

One of the most hotly argued changes was how to define the various ranges of autism. Some advocates opposed the idea of dropping the specific diagnosis for Asperger's disorder. People with that disorder often have high intelligence and vast knowledge on narrow subjects but lack social skills. Some who have the condition embrace their quirkiness and vow to continue to use the label.

And some Asperger's families opposed any change, fearing their kids would lose a diagnosis and no longer be eligible for special services.

But the revision will not affect their education services, experts say.

The new manual adds the term "autism spectrum disorder," which already is used by many experts in the field. Asperger's disorder will be dropped and incorporated under that umbrella diagnosis. The new category will include kids with severe autism, who often don't talk or interact, as well as those with milder forms.

Kelli Gibson of Battle Creek, Mich., who has four sons with various forms of autism, said Saturday she welcomes the change. Her boys all had different labels in the old diagnostic manual, including a 14-year-old with Asperger's.

"To give it separate names never made sense to me," Gibson said. "To me, my children all had autism."

Three of her boys receive special education services in public school; the fourth is enrolled in a school for disabled children. The new autism diagnosis won't affect those services, Gibson said. She also has a 3-year-old daughter without autism.

People with dyslexia also were closely watching for the new updated doctors' guide. Many with the reading disorder did not want their diagnosis to be dropped. And it won't be. Instead, the new manual will have a broader learning disorder category to cover several conditions including dyslexia, which causes difficulty understanding letters and recognizing written words.

The trustees on Saturday made the final decision on what proposals made the cut; recommendations came from experts in several work groups assigned to evaluate different mental illnesses.

The revised guidebook "represents a significant step forward for the field. It will improve our ability to accurately diagnose psychiatric disorders," Dr. David Fassler, the group's treasurer and a University of Vermont psychiatry professor, said after the vote.

The shorthand name for the new edition, the organization's fifth revision of the Diagnostic and Statistical Manual, is DSM-5. Group leaders said specifics won't be disclosed until the manual is published but they confirmed some changes. A 2000 edition of the manual made minor changes but the last major edition was published in 1994.

Olfson said the manual "seeks to capture the current state of knowledge of psychiatric disorders. Since 2000 ... there have been important advances in our understanding of the nature of psychiatric disorders."

Catherine Lord, an autism expert at Weill Cornell Medical College in New York who was on the psychiatric group's autism task force, said anyone who met criteria for Asperger's in the old manual would be included in the new diagnosis.

One reason for the change is that some states and school systems don't provide services for children and adults with Asperger's, or provide fewer services than those given an autism diagnosis, she said.

Autism researcher Geraldine Dawson, chief science officer for the advocacy group Autism Speaks, said small studies have suggested the new criteria will be effective. But she said it will be crucial to monitor so that children don't lose services.

Other changes include:

—A new diagnosis for severe recurrent temper tantrums — disruptive mood dysregulation disorder. Critics say it will medicalize kids' who have normal tantrums. Supporters say it will address concerns about too many kids being misdiagnosed with bipolar disorder and treated with powerful psychiatric drugs. Bipolar disorder involves sharp mood swings and affected children are sometimes very irritable or have explosive tantrums.

—Eliminating the term "gender identity disorder." It has been used for children or adults who strongly believe that they were born the wrong gender. But many activists believe the condition isn't a disorder and say calling it one is stigmatizing. The term would be replaced with "gender dysphoria," which means emotional distress over one's gender. Supporters equated the change with removing homosexuality as a mental illness in the diagnostic manual, which happened decades ago.

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AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner .

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