Comparison of DSM-IV versus proposed DSM-5 diagnostic criteria for eating disorders: Reduction of eating disorder not otherwise specified and validity

2011 ◽  
Vol 44 (6) ◽  
pp. 553-560 ◽  
Author(s):  
Pamela K. Keel ◽  
Tiffany A. Brown ◽  
Jill Holm-Denoma ◽  
Lindsay P. Bodell
2011 ◽  
Vol 198 (1) ◽  
pp. 8-10 ◽  
Author(s):  
Christopher G. Fairburn ◽  
Zafra Cooper

SummaryThe DSM–IV scheme for classifying eating disorders is a poor reflection of clinical reality. In adults it recognises two conditions, anorexia nervosa and bulimia nervosa, yet these states are merely two presentations among many. As a consequence, at least half the cases seen in clinical practice are relegated to the residual diagnosis ‘eating disorder not otherwise specified’. The changes proposed for DSM–5 will only partially succeed in correcting this shortcoming. With DSM–6 in mind, it is clear that comprehensive transdiagnostic samples need to be studied with data collected on their current state, course and response to treatment. Only with such data will it be possible to derive an empirically based classificatory scheme that is both rooted in clinical reality and of value to clinicians.


Author(s):  
Robyn Sysko ◽  
G. Terence Wilson

The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) describes two eating disorder diagnoses, anorexia nervosa (AN) and bulimia nervosa (BN). Provisional criteria are also provided in DSM-IV for binge eating disorder (BED), which is an example of an eating disorder not otherwise specified. This chapter presents a summary and synthesis of research related to the clinical features and treatment of AN, BN, and BED, including studies of prevalence, common comorbidities, and treatment efficacy. Both psychological and pharmacological treatments are reviewed, including cognitive-behavioral therapy, interpersonal psychotherapy, family therapy, and the use of antidepressant medications. Recommendations are made for future research across the eating disorders.


2011 ◽  
Vol 26 (S2) ◽  
pp. 722-722
Author(s):  
S. Gaudio ◽  
C. Bufacchi ◽  
M. Andreotti ◽  
N. Gregorini ◽  
F. Montecchi

IntroductionSeveral research studies have investigated Personality Disorder (PD) comorbidity in adult with Eating Disorders (ED), which showed an association between the two types of disorder.ObjectiveThe aim of this study is to examine the relationships between ED and PD in a sample of adolescents between 14 to 18 years of age.MethodSixty-seven adolescents with ED treated in an outpatients setting [23 Anorexia Nervosa (AN), 17 Bulimia Nervosa (BN) and 27 Eating Disorder Not Otherwise Specified (EDNOS)] were assessed using the Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II), the Beck Depression Inventory (BDI) and the Eating Attitudes Test (EAT).ResultsOverall, 13 (19.4%) of ED patients had one or more PD. Cluster C PDs were the most common specific PDs. No significant difference was found between AN and BN based on the general presence of PDs. EDNOS patients had a lower prevalence of PDs compared to AN and BN patients. ED patients with a PD had an higher BDI rates compared to ED patients without PDs. No significant difference was observed in EAT rates between ED patients with and without PDs.ConclusionsCluster C PDs were the most frequent PDs found in ED adolescent patients. The prevalence of PDs is similar in AN and BN patients, whilst EDNOS patients have a lower prevalence of PDs compared to AN and BN patients. ED adolescent patients with current PD comorbidity show higher depression scores.


BJPsych Open ◽  
2021 ◽  
Vol 7 (5) ◽  
Author(s):  
Zoe M. Jenkins ◽  
Serafino G. Mancuso ◽  
Andrea Phillipou ◽  
David J. Castle

The transition from DSM-IV to DSM-5 relaxed diagnostic criteria for anorexia nervosa and bulimia nervosa, and recognised a third eating disorder, binge eating disorder. However, a large proportion of cases remain in the ill-defined category of ‘other specified feeding and eating disorders’. We sought to investigate the utility of a proposed solution to classify this group further, subdividing based on the dominant clinical feature: binge eating/purging or restraint. Cluster analysis failed to identify clusters in a treatment-seeking sample based on symptoms of restraint, binge eating, purging and over-evaluation of shape and weight. Further investigation of this highly heterogeneous group is required.


2010 ◽  
Vol 178 (3) ◽  
pp. 511-517 ◽  
Author(s):  
Jennifer J. Thomas ◽  
Sherrie S. Delinsky ◽  
Sarah A. St. Germain ◽  
Thomas J. Weigel ◽  
Christopher M. Tangren ◽  
...  

2013 ◽  
Vol 28 (S2) ◽  
pp. 98-98
Author(s):  
C. Foulon

L’individualisation des troubles alimentaires dans le sens d’un excès d’alimentation s’est faite très tardivement par rapport aux troubles dits restrictifs. les critères de la boulimie ont été pour la première fois décrits par Russell en 1976. les troubles alimentaires se sont divisés en Anorexie mentale avec deux sous-types (restrictif et purgatif) et Boulimie dite « normopondérée ». Tous les autres tableaux cliniques qui ne remplissaient pas la totalité des critères d’un de ses deux troubles entraient dans la catégorie des troubles alimentaires non spécifiés « Eating Disorders not Otherwise Specified ou EDNOS » dans le DSM IV TR. Ces catégories ne semblaient pas pertinentes pour décrire l’ensemble de la pathologie et il est apparu nécessaire de les refondre. les critères de diagnostic tels qu’ils étaient proposés ne permettaient pas de décrire des formes modérées de ces troubles et de pouvoir rendre compte du degré de sévérité du symptôme ou de l’existence de stratégies de contrôle du poids. les classifications se sont faites de façon empirique. Parallèlement à ces classifications (DSM IV TR, CIM 10), différents travaux se sont appliqués à prendre en compte une plus grande diversité de symptômes avec en particulier la description du syndrome d’alimentation nocturne « Night Eating Syndrome ou NES ». Le DSM V a intégré ces travaux et a reconnu comme trouble l’hyperphagie boulimique « binge eating disorder » qui se définit comme l’ingestion de grandes quantités de nourriture sur une courte période avec sentiment de perte de contrôle ce qui le différencie du phénomène plus courant de l’hyperphagie qui est associé à moins de problèmes physiques et psychologiques. La conséquence de ces désordres liés à l’excès de nourriture sont le surpoids et surtout l’obésité avec ses conséquences somatiques. Le fait d’avoir une description clinique précise de ces troubles permet de leur appliquer des thérapeutiques pertinentes. les propositions de traitement doivent absolument tenir compte des caractéristiques cliniques et psychologiques des sujets.


2015 ◽  
Vol 27 (4) ◽  
pp. 437-441 ◽  
Author(s):  
Martin Fisher ◽  
Marisol Gonzalez ◽  
Joan Malizio

Abstract Purpose: This study aimed to determine the changes in diagnosis that occur in making the transition from Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria in an adolescent medicine eating disorder program. Methods: During the months of September 2011 through December 2012, a data sheet was completed at the end of each new outpatient eating disorder evaluation listing the patient’s gender, age, ethnicity, weight, height, DSM-IV diagnosis, and proposed DSM-5 diagnosis. Distributions were calculated using the Mann-Whitney and Wilcoxon rank sum analyses to determine differences between diagnostic groups. Results: There were 309 patients evaluated during the 16-month period. DSM-IV diagnoses were as follows: anorexia nervosa, 81 patients (26.2%); bulimia nervosa, 29 patients (9.4%); binge eating disorder, 1 patient (0.3%); and eating disorder not otherwise specified (EDNOS), 198 patients (64.6%). By contrast, DSM-5 diagnoses were as follows: anorexia nervosa, 100 patients; atypical anorexia nervosa, 93 patients; avoidant/restrictive food intake disorder, 60 patients; bulimia nervosa, 29 patients; purging disorder, 18 patients; unspecified feeding or eating disorder, 4 patients; subthreshold bulimia nervosa, 2 patients; subthreshold binge eating disorder, 2 patients; and binge eating disorder, 1 patient. Conclusion: Almost two thirds (64.6%) of the 309 patients had a diagnosis of EDNOS based on the DSM-IV criteria. By contrast, only four patients had a diagnosis of unspecified feeding or eating disorder based on the DSM-5 criteria. These data demonstrate that the goal of providing more specific diagnoses for patients with eating disorders has been accomplished very successfully by the new DSM-5 criteria.


2005 ◽  
Vol 187 (6) ◽  
pp. 573-578 ◽  
Author(s):  
Gabriella Milos ◽  
Anja Spindler ◽  
Ulrich Schnyder ◽  
Christopher G. Fairburn

BackgroundThe stability of eating disorder diagnoses has received little research attention.AimsTo examine the course of the full range of clinical eating disorders.MethodA sample of 192 women with a current DSM–IV eating disorder (55 with anorexia nervosa, 108 with bulimia nervosa and 29 with eating disorder not otherwise specified) were assessed three times over 30 months using a standardised interview.ResultsAlthough the overarching category of ‘eating disorder’ was relatively stable, the stability of the three specific eating disorder diagnoses was low, with just a third of participants retaining their original diagnosis. This was due only in part to remission since the remission rate was low across all three diagnoses.ConclusionsThere is considerable diagnostic flux within the eating disorders but a low overall remission rate. This suggests that underpinning their psychopathology may be common biological and psychological causal and maintaining processes.


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