scholarly journals The classification of bulimic eating disorders: a community-based cluster analysis study

1996 ◽  
Vol 26 (4) ◽  
pp. 801-812 ◽  
Author(s):  
P. J. Hay ◽  
C. G. Fairburn ◽  
H. A. Doll

SynopsisThere is controversy over how best to classify eating disorders in which there is recurrent binge eating. Many patients with recurrent binge eating do not meet diagnostic criteria for either of the two established eating disorders, anorexia nervosa or bulimia nervosa. The present study was designed to derive an empirically based, and clinically meaningful, diagnostic scheme by identifying subgroups from among those with recurrent binge eating, testing the validity of these subgroups and comparing their predictive validity with that of the DSM-IV scheme.A general population sample of 250 young women with recurrent binge eating was recruited using a two-stage design. Four subgroups among the sample were identified using a Ward's cluster analysis. The first subgroup had either objective or subjective bulimic episodes and vomiting or laxative misuse; the second had objective bulimic episodes and low levels of vomiting or laxative misuse; the third had subjective bulimic episodes and low levels of vomiting or laxative misuse; and the fourth was heterogeneous in character. This cluster solution was robust to replication. It had good descriptive and predictive validity and partial construct validity.The results support the concept of bulimia nervosa and its division into purging and non-purging subtypes. They also suggest a possible new binge eating syndrome. Binge eating disorder, listed as an example of Eating Disorder Not Otherwise Specified within DSM-IV, did not emerge from the cluster analysis.

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.


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.


1997 ◽  
Vol 3 (1) ◽  
pp. 2-8 ◽  
Author(s):  
Christopher G. Fairburn

This article is about the management of eating disorders in which binge eating is a prominent feature. These disorders include bulimia nervosa, the most common eating disorder, and ‘binge eating disorder’, a provisional new diagnosis included in DSM–IV. In addition, binge eating is seen in anorexia nervosa and in many atypical eating disorders.


Cephalalgia ◽  
1997 ◽  
Vol 17 (20_suppl) ◽  
pp. 25-28 ◽  
Author(s):  
A Verri ◽  
Re Nappi ◽  
E Vallero ◽  
C Galli ◽  
G Sances ◽  
...  

Premenstrual Dysphoric Disorder (PMDD) can be differentiated from Premenstrual Syndrome (PMS) by the use of the research criteria provided by the Diagnostic and Statistical Manual (DSM) IV. Indeed, PMS corresponds to mild clinical symptoms, such as breast tenderness, bloating, headache and concomitant minor mood changes, while premenstrual magnification occurs when physical and psychological symptoms of a concurrent axis I disorder get worse during the late luteal phase. Changes in appetite and eating behavior have been documented in women suffering from PMS, with an increased food intake occurring during the luteal phase. Moreover, in women with PMS, a major effect of the phase of the menstrual cycle on appetite has been documented and a high correlation with self-ratings of mood, particularly depression, has been described only in such disturbance. The aim of the present study was to analyse the clinical similarities between PMDD and Eating Disorders (in particular Bulimia Nervosa and Binge Eating Disorder). Thus, we compared the DSM III-R comorbidity, the personality dimensions and the eating attitudes in these patients, attempting to identify any relationship between groups. Twelve PMDD women (mean age 28 years), diagnosed using DSM IV criteria and premenstrual assessor form, were compared with 10 eating disorder (ED) women (6 Bulimia Nervosa, 4 Binge Eating Disorder) (mean age 25 years) and with 10 control women matched for age. The following instruments were used: (i) clinical interview with DSM III-R criteria (SCID); (ii) a psychometric study with TPQ for the evaluation of three personality dimensions (novelty seeking, harm avoidance and reward dependence); (iii) EAT/26 for the evaluation of eating attitudes. Results show that a high comorbidity for mood and anxiety disorders in PMDD and ED is well documented. Our PMDD patients share a 16.6% of comorbidity with ED, whereas such an association is present onlv in 2.3% of the general population. In addition, as a common clue, the personality dimension, harm avoidance, linked to a serotonin mediation is significantly more frequent in PMDD and ED than in normal controls. In conclusion: from the present study it seems clear that a certain degree of similarity exists between the PMDD and ED. However, whether or not these two disorders really share common ground from a physiopathological point of view still has to be clarified by more extensive studies.


Author(s):  
Katherine A. Halmi

Psychological comorbidity of eating disorders may be organized most conveniently according to psychiatric diagnoses of the Diagnostic and Statistical Manual–IV (DSM-IV) and assessments of specific traits. In this chapter, further categorization of the DSM-IV diagnoses is made according to Axis I and Axis II diagnoses (American Psychiatric Association [APA], 1994). The most comprehensive psychological comorbidity study is from the U.S. national comorbidity survey replication (Hudson et al., 2008). In this study, at least one lifetime comorbid psychiatric DSM-IV disorder was present in 56.2% of anorexia nervosa participants, 94.5% of those with bulimia nervosa, 78.9% of those with binge eating disorder, 63.6% with subthreshold binge eating disorder, and 76.5% with any binge eating. Similar results were obtained with other population based studies and also from studies of clinical populations containing the diagnoses of anorexia nervosa, bulimia nervosa, and binge eating disorder (Braun, Sunday, & Halmi, 1994; Godart et al., 2002; Halmi et al., 1991; Hudson et al., 1987; Johnson et al., 2001; Kaye et al., 2004; McElroy et al., 2005).


2004 ◽  
Vol 34 (6) ◽  
pp. 1035-1045 ◽  
Author(s):  
DAVID CLINTON ◽  
ERIC BUTTON ◽  
CLAES NORRING ◽  
ROBERT PALMER

Introduction. The optimal classification of eating disorders has been a matter of considerable debate. The present paper tackles this issue using cluster analysis with large independent samples of eating-disorder patients.Method. Two samples of adult female patients from Sweden (n=631) and England (n=472) were classified on the basis of 10 key clinical variables of primary significance for diagnosing eating disorders. A separate series of cluster analyses were conducted on each sample.Results. Results suggested that a three-cluster solution was optimal in both samples. The first cluster (‘generalized eating disorder’) was characterized by high levels of eating-disorder psychopathology on all variables except weight and menstrual functioning. The second cluster (‘anorexics’) was typified by low weight, amenorrhoea and the absence of binge eating, and seemed to correspond to the clinical picture of anorexia nervosa. The third cluster (‘overeaters’) was characterized by high weight and moderate levels of binge eating and compensatory behaviour.Conclusions. Results suggest that patients presenting to eating-disorder services in different countries have clinical features that fall into very similar patterns. These patterns resemble, but are not identical to, existing diagnostic categories.


Author(s):  
Susan McElroy ◽  
Anna I. Guerdjikova ◽  
Nicole Mori ◽  
Paul E. Keck

This chapter addresses the pharmacotherapy of the eating disorders (EDs). Many persons with EDs receive pharmacotherapy, but pharmacotherapy research for EDs has lagged behind that for other major mental disorders. This chapter first provides a brief rationale for using medications in the treatment of EDs. It then reviews the data supporting the effectiveness of specific medications or medication classes in treating patients with anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other potentially important EDs, such as night eating syndrome (NES). It concludes by summarizing these data and suggesting future areas for research in the pharmacotherapy of EDs.


Author(s):  
Susan L. McElroy ◽  
Anna I. Guerdjikova ◽  
Anne M. O’Melia ◽  
Nicole Mori ◽  
Paul E. Keck

Many persons with eating disorders (EDs) receive pharmacotherapy, but pharmacotherapy research for EDs has lagged behind that for other major mental disorders. In this chapter, we first provide a brief rationale for using medications in the treatment of EDs. We then review the data supporting the effectiveness of specific medications or medication classes in treating patients with anorexia nervosa (AN), bulimia nervosa, binge eating disorder (BED), and other potentially important EDs, such as night eating syndrome (NES) and sleep-related eating disorder (SRED). We conclude by summarizing these data and suggesting future areas for research in the pharmacotherapy of EDs.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
C. Novara ◽  
E. Maggio ◽  
S. Piasentin ◽  
S. Pardini ◽  
S. Mattioli

Abstract Background Orthorexia Nervosa (ON) is a construct characterized by behaviors, emotions, and beliefs on eating healthy food and excessive attention to diet; moreover, dieting has been considered a risk factor in ON symptoms development. The principal aim of this study was to investigate the differences in clinical and non-clinical groups most at risk of ON. Aspects that could be associated with ON (Eating Disorders [EDs], obsessive-compulsive symptomatology, perfectionistic traits, anxiety, depression, Body Mass Index [BMI]) were investigated in all groups. Methods The sample consisted of 329 adults belonging to four different groups. Three were on a diet: Anorexia/Bulimia Nervosa group (N = 90), Obesity/Binge Eating Disorder group (N = 54), Diet group (N = 91). The Control group consisted of people who were not following a diet (N = 94). Participants completed several self-administered questionnaires (EHQ-21, EDI-3, OCI-R, MPS, BAI, BDI-II) to assess ON-related features in different groups. Results Analyses highlighted higher orthorexic tendencies in Anorexia/Bulimia Nervosa, Obesity/BED, and Diet groups than in the Control group. Moreover, results have shown that in the AN/BN group, eating disorders symptomatology and a lower BMI were related to ON and that in Obesity/Binge Eating Disorder and Diet groups, perfectionism traits are associated with ON. Conclusion Individuals who pursue a diet share some similarities with those who have an eating disorder regarding emotions, behaviors, and problems associated with orthorexic tendencies. Moreover, perfectionistic traits seem to predispose to higher ON tendencies. In general, these results confirm the ON as an aspect of the main eating disorders category.


Author(s):  
Marco La Marra ◽  
Walter Sapuppo ◽  
Giorgio Caviglia

The aim of this study has been to investigate the dissociative phenomena and the difficulties related to perceive, understand and describe the proper ones and other people's emotional states in a sample of 53 patients with Eating Disorders. The recruited sample is made by 14 Anorexia Nervosa (AN) patients, 15 with Bulimia Nervosa (BN), 12 with Eating Disorder Non Otherwise Specified (EDNOS) and 12 with Binge Eating Disorder (BED). To all subjects was administred the Eating Disorder Inventory-2, the Dissociative Experiences Scale and the Scala Alessitimica Romana. In according with literature, we confirme the relationships among Eating Disorders, the dissociative phenomena and Alexithymia.


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