The prevalence of DSM-IV personality pathology among individuals with bulimia nervosa, binge eating disorder and obesity

2003 ◽  
Vol 33 (7) ◽  
pp. 1311-1317 ◽  
Author(s):  
P. VAN HANSWIJCK DE JONGE ◽  
E. F. VAN FURTH ◽  
J. HUBERT LACEY ◽  
G. WALLER
Keyword(s):  
Eating Disorder ◽  
Personality Disorder ◽  
Bulimia Nervosa ◽  
Binge Eating ◽  
Personality Disorders ◽  
Binge Eating Disorder ◽  
Personality Pathology ◽  
Obese Patients ◽  
Binge Eaters ◽  
Dsm Iv

Background. There are numerous reports of personality disorder pathology in different eating disorders. However, few studies have directly compared personality pathology in bulimia nervosa, binge eating disorder and obesity. The present study examines group differences in DSM-IV personality pathology, considering the potential utility of understanding personality disorders in terms of diagnosis and dimensional scores.Method. Eating disorder diagnoses were established using the Eating Disorder Examination interview. Thirty-five bulimia nervosa patients, 15 binge eating disorder patients and 37 obese patients were assessed and compared on the International Personality Disorder Examination using categorical and dimensional personality disorder scores.Results. For most personality disorders, there was a dichotomy of binge eaters versus non-binge eaters. In contrast, there was a continuum of severity in borderline personality disorder pathology between the groups. The dimensional system of measurement of personality pathology allowed for clearer differentiation between the groups.Conclusion. The study strongly indicates that personality disorder difficulties are present in patients who binge eat, while obese patients who do not binge eat display significantly less personality disorder pathology. Assessment of bulimia nervosa, binge eating disorder and obesity needs to address personality disorders and pathology. Dimensional markers of personality pathology can be used to supplement categorical diagnoses, providing information about the traits that underlie diagnosis.

Eating behaviour, eating disorder and obesity

2000 ◽  
Vol 57 (8) ◽  
pp. 504-510 ◽  
Author(s):  
Zipfel ◽  
Löwe ◽  
Herzog
Keyword(s):  
Eating Disorder ◽  
Bulimia Nervosa ◽  
Binge Eating ◽  
Binge Eating Disorder ◽  
Eating Behaviour ◽  
Diagnostische Kriterien ◽  
Affektive Störungen ◽  
Therapeutische Optionen ◽  
Dsm Iv

Die Ernährungs- und Bewegungssituation sowie die sozioökonomischen Umstände haben sich in den vergangenen 50 Jahren in den entwickelten Ländern radikal gewandelt. Folgen dieser Entwicklung sind rasante Steigerungen der Prävalenzraten, insbesondere der Adipositas. Kontrastierend hierzu wird weiterhin ein ausgeprägtes Schlankheitsideal propagiert. Dieses Spannungsfeld ist mitverantwortlich für eine steigende Inzidenz von Essstörungen. Hierzu gehören im Gewichtsspektrum des Normal- bis Übergewichtes die Bulimia nervosa und die Esssucht, bisher noch mit dem englischen Begriff der «Binge-Eating-Disorder» bezeichnet. Obwohl die Bulimia Nervosa bereits 1980 in die DSM-III Kriterien aufgenommen wurde, ergaben Untersuchungen, dass bislang nur etwa 12 Prozent der Betroffenen von den Hausärzten entdeckt und richtig diagnostiziert werden. Ein Grund dieser erschreckend niedrigen Zahl liegt in der Dynamik der Erkrankung, mit einer ausgeprägten Tendenz der Patientinnen zur Verheimlichung, ein weiterer Grund mag in einer noch unzureichenden Aufklärung der Hausärzte liegen. Deshalb werden diagnostische Kriterien und therapeutische Optionen dargestellt. Essstörungen im Bereich des Übergewichtes werden seit dem DSM-IV (1994) im Wesentlichen unter dem Begriff der «Binge-Eating-Disorder (BED)» zusammengefasst. 20–30% der adipösen Patienten, die sich in Gewichtsreduktionsprogrammen befinden, leiden unter dieser Essstörung. Erste Untersuchungsergebnisse zeigen, dass diese Subgruppe der Adipösen eine modifizierte Behandlung mit einer stärkeren Fokussierung auf eine Psychotherapie bedarf. Über die initiale Abklärung einer möglichen Essstörung hinaus sollten auch affektive Störungen (Depressivität und Ängstlichkeit) oder ein gestörtes Körperbild erfasst werden. Falls Hinweise auf eine ausgeprägte Störung in diesen Bereichen vorliegen, sollte Psychotherapie fester Bestandteil eines integrierten Therapiekonzeptes der Adipositas sein.

scholarly journals DoDSM-5Eating Disorder Criteria Overpathologize Normative Eating Patterns among Individuals with Obesity?

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Jennifer J. Thomas ◽  
Katherine A. Koh ◽  
Kamryn T. Eddy ◽  
Andrea S. Hartmann ◽  
Helen B. Murray ◽  
...  
Keyword(s):  
Eating Disorder ◽  
Bulimia Nervosa ◽  
Binge Eating ◽  
Binge Eating Disorder ◽  
Interrater Reliability ◽  
Clinical Interview ◽  
Point Prevalence ◽  
Eating Patterns ◽  
Dsm 5 ◽  
Dsm Iv

Background.DSM-5revisions have been criticized in the popular press for overpathologizing normative eating patterns—particularly among individuals with obesity. To evaluate the evidence for this and otherDSM-5critiques, we compared the point prevalence and interrater reliability ofDSM-IVversusDSM-5eating disorders (EDs) among adults seeking weight-loss treatment.Method.Clinicians (n=2) assignedDSM-IVandDSM-5ED diagnoses to 100 participants via routine clinical interview. Research assessors (n=3) independently conferred ED diagnoses via Structured Clinical Interview forDSM-IVand aDSM-5checklist.Results. Research assessors diagnosed a similar proportion of participants with EDs underDSM-IV(29%) versusDSM-5(32%).DSM-5research diagnoses included binge eating disorder (9%), bulimia nervosa (2%), subthreshold binge eating disorder (5%), subthreshold bulimia nervosa (2%), purging disorder (1%), night eating syndrome (6%), and other (7%). Interrater reliability between clinicians and research assessors was “substantial” for bothDSM-IV(κ= 0.64, 84% agreement) andDSM-5(κ= 0.63, 83% agreement).Conclusion.DSM-5ED criteria can be reliably applied in an obesity treatment setting and appear to yield an overall ED point prevalence comparable toDSM-IV.

Eating disorders in adolescents: how does the DSM-5 change the diagnosis?

2015 ◽  
Vol 27 (4) ◽  
pp. 437-441 ◽  
Author(s):  
Martin Fisher ◽  
Marisol Gonzalez ◽  
Joan Malizio
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Bulimia Nervosa ◽  
Binge Eating ◽  
Binge Eating Disorder ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Dsm Iv

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.

The Aversiveness of Specific Emotional States Associated with Binge-Eating in Obese Subjects

1996 ◽  
Vol 30 (6) ◽  
pp. 839-844 ◽  
Author(s):  
Justin Kenardy ◽  
Bruce Arnow ◽  
W. Stewart Agras
Keyword(s):  
Eating Disorder ◽  
Binge Eating ◽  
Binge Eating Disorder ◽  
Negative Mood ◽  
Emotional States ◽  
Trade Off ◽  
Binge Eaters ◽  
Before And After ◽  
Obese Subjects ◽  
Dsm Iv

Objective: The aim of this study was to examine the hypothesis that non-purge-related binge-eating in obesity is maintained by a ‘trade-off’ in which a highly aversive emotional state is exchanged for a less aversive state. Method: Ninety-eight obese binge-eaters meeting the DSM-IV criteria for binge-eating disorder [1] were contrasted with 65 non-binge-eating controls on their perceived distress associated with negative mood states usually experienced before and after binges. Results: Binge-eaters reported significantly greater distress and lower tolerance of negative mood compared to controls. Furthermore, when compared with controls, binge-eaters reported that emotions typically reported before binges (e.g. anger) were more aversive than those reported after (e.g. guilt). Conclusions: These results were interpreted as supporting the ‘trade-off’ theory and have implications for the treatment of binge-eating disorder.

scholarly journals The management of bulimia nervosa and other binge eating problems

1997 ◽  
Vol 3 (1) ◽  
pp. 2-8 ◽  
Author(s):  
Christopher G. Fairburn
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Bulimia Nervosa ◽  
Binge Eating ◽  
Binge Eating Disorder ◽  
Eating Problems ◽  
Prominent Feature ◽  
Dsm Iv ◽  
New Diagnosis

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.

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