The validity of the DSM-IV scheme for classifying bulimic eating disorders

Authors

  • Phillipa Hay,

    Corresponding author
    1. University Department of Psychiatry, University of Oxford, Oxford, United Kingdom
    • Department of Psychiatry, University of Adelaide, Royal Adelaide Hospital, North Terrace, Adelaide SA, 5001, Australia
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  • Christopher Fairburn

    1. University Department of Psychiatry, University of Oxford, Oxford, United Kingdom
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Abstract

Objective

This study was designed to assess the validity of the DSM-IV scheme for classifying recurrent binge eating. Method: A general population sample of 250 young women with recurrent binge eating was recruited using a two—stage design. Information on their eating habits and associated psychopathology was obtained by personal interviews. Subjects were reassessed 1 year later. Results: The diagnosis of bulimia nervosa had good descriptive and predictive validity. On present state features it was not possible to distinguish binge-eating disorder from the nonpurging subtype of bulimia nervosa. However, these groups differed in their outcome at 1 year. Within eating disorder not otherwise specified (EDNOS), there was a subgroup of subjects with milder symptoms which were relatively unstable over time. Discussion: The findings suggest that bulimic eating disorders exist on a continuum of clinical severity, from bulimia nervosa purging type (most severe), through bulimia nervosa nonpurging type (intermediate severity), to binge-eating disorder (least severe). The data on outcome support retaining a distinction between nonpurging bulimia nervosa and binge-eating disorder. © 1998 by John Wiley & Sons, Inc. Int J Eat Disord 23: 7–15, 1998.

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