Yoshikatsu Nakai1, Kazuko Nin2, Shun'ichi Noma3, Satoshi Teramukai4, Kei Fujikawa5, Stephen A Wonderlich6. 1. Kyoto Institute of Health Sciences, Kyoto, Japan. 2. School of Health Sciences, Faculty of Medicine, Kyoto University, Kyoto, Japan. 3. Department of Psychiatry, School of Medicine, Kyoto University, Kyoto, Japan. 4. Department of Biostatistics, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan. 5. The Center for Quality Assurance in Research and Development, Kyoto Prefectural University of Medicine, Kyoto, Japan. 6. Department of Clinical Neuroscience, University of North Dakota, School of Medicine and Health Sciences, Fargo, North Dakota.
Abstract
OBJECTIVE: To examine the impact of the DSM-5 on the diagnoses and severity indicators of eating disorders, we conducted a comparative study on the classification of eating disorders including subtypes of anorexia nervosa (AN) between the DSM-IV and DSM-5 criteria. In addition, we studied the association of the DSM-5 severity criteria and clinical variables. METHOD: Participants were 304 outpatients, aged 16-45 years, with eating disorders, diagnosed using semi-structured clinical interviews and the eating disorder examination questionnaire (EDE-Q). The severity of AN, bulimia nervosa (BN), and binge-eating disorder (BED) was rated from mild to extreme using the DSM-5 severity criteria. RESULTS: The DSM-5 remarkably reduced the number of diagnoses in the residual category from 37.5% to 9.2% and effectively differentiated the diagnostic groups in eating disorder psychopathology. Unexpectedly, however, the scores of all the EDE-Q subscales significantly decreased as severity ratings increased in the DSM-5 AN. Furthermore, while the AN binge-eating/purging group reported significantly lower severity ratings than the AN restricting group, the former displayed more severe eating disorder psychopathology than the latter. In the BN and BED groups, the level of eating concern increased as severity ratings increased, but the severity groups did not differ on other eating pathology variables. DISCUSSION: The DSM-5 effectively reduced the reliance on residual categories and differentiated the diagnostic groups in eating disorder psychopathology. However, our findings show limited support for the DSM-5 severity specifiers for eating disorders. It is necessary to test additional clinical or functional variables for severity specifiers across eating disorders.
OBJECTIVE: To examine the impact of the DSM-5 on the diagnoses and severity indicators of eating disorders, we conducted a comparative study on the classification of eating disorders including subtypes of anorexia nervosa (AN) between the DSM-IV and DSM-5 criteria. In addition, we studied the association of the DSM-5 severity criteria and clinical variables. METHOD:Participants were 304 outpatients, aged 16-45 years, with eating disorders, diagnosed using semi-structured clinical interviews and the eating disorder examination questionnaire (EDE-Q). The severity of AN, bulimia nervosa (BN), and binge-eating disorder (BED) was rated from mild to extreme using the DSM-5 severity criteria. RESULTS: The DSM-5 remarkably reduced the number of diagnoses in the residual category from 37.5% to 9.2% and effectively differentiated the diagnostic groups in eating disorder psychopathology. Unexpectedly, however, the scores of all the EDE-Q subscales significantly decreased as severity ratings increased in the DSM-5 AN. Furthermore, while the AN binge-eating/purging group reported significantly lower severity ratings than the AN restricting group, the former displayed more severe eating disorder psychopathology than the latter. In the BN and BED groups, the level of eating concern increased as severity ratings increased, but the severity groups did not differ on other eating pathology variables. DISCUSSION: The DSM-5 effectively reduced the reliance on residual categories and differentiated the diagnostic groups in eating disorder psychopathology. However, our findings show limited support for the DSM-5 severity specifiers for eating disorders. It is necessary to test additional clinical or functional variables for severity specifiers across eating disorders.
Authors: Lazaro V Zayas; Shirley B Wang; Kathryn Coniglio; Kendra Becker; Helen B Murray; Eric Klosterman; Brian Kay; Pamela Bean; Theodore Weltzin; Debra L Franko; Kamryn T Eddy; Jennifer J Thomas Journal: Int J Eat Disord Date: 2018-09-07 Impact factor: 4.861
Authors: Francesco Borgia; Plinio Cirillo; Maria Pia Riccio; Francesco Raimondi; Danilo Franco; Luigi Scippa; Adriana Franzese; Giovanni Esposito; Nicola De Luca; Carmela Bravaccio Journal: Eur J Pediatr Date: 2021-05-28 Impact factor: 3.183