This Article is being co-published by the International Journal of Eating Disorders and the American Psychiatric Association.
Special Section Review Article/Eating Disorders in DSM-V: Review of Existing Literature (Part 1)
Validity and utility of subtyping anorexia nervosa†
Article first published online: 13 JUL 2009
Copyright © 2009 American Psychiatric Association
International Journal of Eating Disorders
Volume 42, Issue 7, pages 590–594, November 2009
How to Cite
Peat, C., Mitchell, J. E., Hoek, H. W., Wonderlich, S. A. (2009), Validity and utility of subtyping anorexia nervosa. Int. J. Eat. Disord., 42: 590–594. doi: 10.1002/eat.20717
- Issue published online: 16 OCT 2009
- Article first published online: 13 JUL 2009
- Manuscript Accepted: 9 JUN 2009
- NIH. Grant Number: R13 MH177443
The purpose of this article is to review the available literature that addresses the predictive validity and utility of subtyping patients with anorexia nervosa (AN) into binge/purge and restrictor subtypes.
Literature was reviewed including studies that compared individuals with subtype diagnoses on clinical and outcome variables as well as more recent research examining the frequency of diagnostic crossover.
Several studies found that in general the binge/purge subtype patients have more psychopathology, tend to be older, and tend to have a worse outcome. More recent studies which have examined diagnostic crossover suggest that the rate of crossover from the restrictor subtype to the binge/purge subtype is substantial. Crossover from the binge/purge to the restrictor subtype appears to occur less commonly. There is also literature documenting crossover from AN to bulimia nervosa (BN) and a small literature looking at crossover from BN to AN.
The results of this article suggest that although there is generally progression from restrictor AN to binge/purge AN to BN in a sizeable number of patients, other crossover patterns can be seen as well and the amount of crossover is quite large. This suggests a lack of predictive validity for subtypes. © 2009 American Psychiatric Association. Int J Eat Disord 2009