This study investigated the changes in rates of AN, BN and EDNOS diagnoses after applying the DSM-5 eating disorder criteria to a clinical sample. STATA 12.1 (StataCorp, College Station, Tx) was used to analyse the data. The authors declare that they have no competing interests. The documentation of mealtime behaviours such as persistent behaviour that interferes with weight gain and attitude to the seriousness of a low bodyweight enabled this information to be retrospectively applied to DSM-5 criteria.Įthics approval was obtained from the St Vincent’s Human Resource Ethics Committee. The authors note that atypical AN would be an alternate way of describing these individuals, however for the purpose of this study only the differentiation from OSFED/UFED is relevant. It was decided to include these individuals who had rapid weight loss or high premorbid weight in the AN group due to the similarities with the rest of the AN group in every other respect. In this study we considered patients with a BMI <18.5 kg/m 2 to fulfil DSM-5 criterion A, as well as those with a BMI over 18.5 kg/m 2 who could still be considered to be at a significantly low weight due to persistent restriction of energy intake. A single researcher reviewed this data and the clinical notes retrospectively.Īfter reviewing the files, DSM-5 and DSM-IV criteria were applied to all participants retrospectively. Behaviour of participants around meal times and cooperation with the program was documented in the clinical file. The majority of participants were Australian born females from an Anglo-Saxon background, which could limit the application of these findings to other populations.Ĭlinicians trained in using a structured documentation suite and the Mini International Neuropsychiatric Interview (MINI) Version ICD-10 interviewed the participants at the time of the initial assessment. All patients who were diagnosed with a DSM-IV eating disorder were included in the study. However this study was unable to examine the reliability of the new diagnostic criteria or the impact of DSM-5 on binge eating disorder.ĭata came from 285 consecutive patients over the age of 17 who attended an outpatient clinic for eating disorders in Melbourne, Australia, from 2009 to 2014. ConclusionsĭSM-5 has reduced the reliance on EDNOS. The removal of Criterion D, amenorrhoea, was the leading cause for transition from EDNOS to AN. We observed a 23.5% reduction in the diagnosis of OSFED/UFED with the implementation of DSM-5 compared to EDNOS with DSM-IV. Information in the clinical records included structured clinical interviews, and self-rating scales of eating disorder and other psychiatric symptoms and a longitudinal narrative of patient performance and attitude during observed meals. The referral process may also have been skewed towards AN, BN and EDNOS due to a perception by referring parties that binge eating disorder was a ‘milder’ condition that did not require specialist intervention. It is possible that individuals with binge eating disorder were not referred to the clinic following the initial referral and assessment due to the lack of binge eating specific interventions available.
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This is surprising given the prevalence of binge eating disorder in the community. No patients were diagnosed with binge eating disorder during the study period. All patients who had attended the clinic and received an eating disorder diagnosis during this period were included in the study. The clinical records of patients with diagnoses of anorexia nervosa (AN), bulimia nervosa (BN) and EDNOS were retrospectively assessed using the DSM-5 criteria. MethodsĢ85 participants were recruited from a specialised eating disorder clinic in Australia over a 5-year period from 2009 until 2014. It also aims to compare the psychopathology between the EDNOS and OSFED/UFED groups. This study aims to evaluate the changes in percentages of patients in a residual DSM-IV category compared to a residual DSM-5 category by retrospectively applying DSM-5 criteria to the clinical records of a patient population in a clinical setting. In DSM-5 the residual category is renamed Other Specified Feeding and Eating Disorders (OSFED) and Unspecified Eating Disorders (UFED) however the diagnostic criteria for the residual category in each of the diagnostic systems remains the same. DSM-IV resulted in a large number of patients being diagnosed with Eating Disorder Not Otherwise Specified (EDNOS).
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This study compares the DSM-IV and DSM-5 diagnostic criteria for eating disorders.