Eating Disorders

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.

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.


Author(s):  
Kathryn H. Gordon ◽  
Jill M. Holm-Denoma ◽  
Ross D. Crosby ◽  
Stephen A. Wonderlich

The purpose of the chapter is to elucidate the key issues regarding the classification of eating disorders. To this end, a review of nosological research in the area of eating disorders is presented, with a particular focus on empirically based techniques such as taxometric and latent class analysis. This is followed by a section outlining areas of overlap between the current Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition, Text Revision (DSM-IV-TR; American Psychiatric Association, 2000) eating disorder categories and their symptoms. Next, eating disorder classification models that are alternatives to the DSM-IV-TR are described and critically examined in light of available empirical data. Finally, areas of controversy and considerations for change in next version of the DSM (i.e., the applicability of DSM criteria to minority groups, children, males; the question of whether clinical categories should be differentiated from research categories) are discussed.


1997 ◽  
Vol 12 (7) ◽  
pp. 342-344 ◽  
Author(s):  
P Cotrufo ◽  
V Barretta ◽  
P Monteleone

SummaryIn this study, we investigated the prevalence of full syndrome (FS), partial syndrome (PS) and subclinical syndrome (SCS) eating disorders in a sample of 356 high school girls. We identified two cases of anorexia nervosa (0.56%), 14 of bulimia nervosa (3.94%) and one of binge eating disorder (0.28%) according to Diagnostic and Statistical Manual (DSM)-IV. Moreover, 17 girls (4.77%) were recognized as PS cases and 49 (13.7%) as SCS cases. A follow-up is now ongoing to explore the clinical evolution of partial and subclinical syndromes.


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.


1995 ◽  
Vol 40 (8) ◽  
pp. 445-456 ◽  
Author(s):  
Paul E Garfinkel ◽  
Sidney H Kennedy ◽  
Allan S Kaplan

Objective To highlight developments in the taxonomy of eating disorders since Russell's original description of bulimia nervosa (BN) in 1979 and through 3 versions of the Diagnostic and Statistical Manual. Method Criteria for anorexia nervosa (AN), BN and binge eating disorder (BED) are systematically described. Results While criteria for AN remain largely unchanged between DSM-III-R and DSM-IV, the subclassification of binge/purge and restricter subgroups endorses previous research findings. For BN, the definition of “binge” has occupied considerable attention both in quantitative and qualitative terms. The arbitrary choice of 2 episodes per week as a minimum frequency is also discussed in light of recent data from the Ontario Health Supplement. A third eating disorder, BED, is now included in the appendix of DSM-IV under Eating Disorders — Not Otherwise Specified category. The potential overlap between this disorder and nonpurging BN is discussed. Finally, the relationship between eating disorders and other psychiatric disorders including depression, schizophrenia, obsessional, and conversion disorders is considered as well as the continuum from preoccupation with weight to eating disorder. Conclusion While significant advances have been made in understanding and classifying eating disorders during the past 15 years, further empirical work is necessary to clarify areas of uncertainty.


CNS Spectrums ◽  
2000 ◽  
Vol 5 (1) ◽  
pp. 60-66 ◽  
Author(s):  
Dan J. Stein ◽  
Donald W. Black ◽  
Willie Pienaar

AbstractParaphilias are recurrent and intense sexually arousing fantasies, sexual urges, or behaviors generally involving nonhuman objects. These paraphilias cause the suffering or humiliation of the patient or patient's partner, or children, or other nonconsenting persons. However, in many patients symptoms involve more culturally acceptable patterns (eg, repetitive masturbation, Internet pornography); such hypersexual symptoms have been labeled as compulsive, addictive, or impulsive. Growing evidence supports the existence of a discrete syndrome characterized by recurrent and intense sexually arousing fantasies, sexual urges, or behaviors involving patterns that fall outside the definition of paraphilia. There is, however, high comorbidity with paraphilia. While such symptoms have been labeled as sexual compulsion or addiction, these terms are problematic in this context. Modern nosology has neglected this entity, although the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), category of sexual disorders not otherwise specified includes hypersexual behaviors as an example. We suggest that the DSM-IV category of sexual disorders be modified to include explicitly diagnostic criteria for a disorder characterized by hypersexual symptoms involving patterns that fall outside of the current definition of paraphilia. The disorder might be classified as one of the paraphilias, or as paraphilia-related. In the absence of a comprehensive understanding of the pathogenesis of this disorder, we suggest that it simply be termed hypersexual disorder.


2015 ◽  
Vol 22 (13) ◽  
pp. 1289-1296 ◽  
Author(s):  
Dara E. Babinski ◽  
James G. Waxmonsky ◽  
Daniel A. Waschbusch ◽  
William E. Pelham

Objective: Several studies suggest that parental ADHD impedes behavioral parent training (BPT) outcomes. Parental ADHD symptoms exhibited during BPT may interfere with the acquisition of new skills. This study explored the observed behavior of parents with ADHD during BPT. Method: Parents of children with ADHD attending group BPT completed self-ratings of their ADHD symptoms. Parents indicating a moderate level of ADHD symptoms were administered a clinical interview, and 37.3% of parents met ADHD criteria based on Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) clinician-rated symptom counts. Results: Parents with high ADHD symptoms displayed more total and off-task violations compared with parents with low ADHD symptoms, although no significant differences emerged for other behaviors (i.e., working quietly, using materials appropriately, and remaining in seat), absences, or tardiness. Conclusion: Parental ADHD symptoms were manifested during BPT. Future research should clarify the nature of parental behavior in BPT as a possible mechanism explaining the relation between parental ADHD and impaired BPT outcomes.


CNS Spectrums ◽  
2016 ◽  
Vol 21 (4) ◽  
pp. 304-309 ◽  
Author(s):  
Stefano Erzegovesi ◽  
Laura Bellodi

Twenty years have passed from the International Classification of Diseases, Tenth Revision (ICD-10) to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and, in the meanwhile, a lot of research data about eating disorders has been published. This article reviews the main modifications to the classification of eating disorders reported in the “Feeding and Eating Disorders” chapter of the DSM-5, and compares them with the ICD-10 diagnostic guidelines. Particularly, we will show that DSM-5 criteria widened the diagnoses of anorexia and bulimia nervosa to less severe forms (so decreasing the frequency of Eating Disorders, Not Otherwise Specified (EDNOS) diagnoses), introduced the new category of Binge Eating Disorder, and incorporated several feeding disorders that were first diagnosed in infancy, childhood, or adolescence. On the whole, the DSM-5 revision should allow the clinician to make more reliable and timely diagnoses for 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.


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