The position of
selective mutism disorder - SM - has been modified in the last edition of the classification of
mental disorders DSM-5. It was removed from "Disorders of childhood and adolescence" and placed in "
Anxiety disorders". This caused two important changes in the interpretation of the symptoms of
selective mutism. It highlighted anxious etiology of the disorder and also open the possibility to diagnose
selective mutism in adults as a special category of
anxiety disorders. The aim of this study was to present three different cases concerning the diagnostic difficulties of
selective mutism (the child, the teenager and the persons who became adult during our observation) regarding current views on SM. In this study we presented the current view on the etiology, course and available
therapies for
selective mutism. Owing to updating the clinical knowledge about SM and describing three cases, we highlighted the controversies around the diagnosis and treatment of this disorder.
Selective mutism might be a preliminary diagnosis, often leading to the diagnosis of other disorders of diverse etiology and course. Among the psychiatric aspects of the disorder, the 'anxiety component' of SM is crucial. In individuals with
selective mutism, developmental disorders, social cognition and neurocognition deficits or dysfunctions of auditory processing often coexist. The severity and the type of comorbidities may determine the future course of the illness and the final effects of the
therapy.