DSM-5 reduces the proportion of ednos cases: Evidence from community samples

Authors

  • Paulo P.P. Machado PhD,

    Corresponding author
    1. Psychotherapy and Psychopathology Research Unit–CIPsi, School of Psychology, University of Minho, Braga, Portugal
    • Psychotherapy and Psychopathology Research Unit – CIPsi, School of Psychology, University of Minho, Campus de Gualtar, P-4710 BRAGA, Portugal
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  • Sónia Gonçalves PhD,

    1. Psychotherapy and Psychopathology Research Unit–CIPsi, School of Psychology, University of Minho, Braga, Portugal
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  • Hans W. Hoek MD, PhD

    1. Parnassia Bavo Academy, Parnassia Psychiatric Institute, The Hague, The Netherlands
    2. Department of Epidemiology, Columbia University, New York
    3. Department of Psychiatry, University of Groningen, Groningen, The Netherlands
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Abstract

Objective:

Eating Disorder Not Otherwise Specified (EDNOS) constitute the most common eating disorder among those seeking treatment at eating disorder facilities; they are even more common among persons with eating disorders the community. This study compares the impact of applying the revised diagnostic criteria proposed by the DSM-5 workgroup, and the broad categories for the diagnosis of eating disorders (BCD-ED) proposed by Walsh and Sysko on the prevalence of EDNOS.

Method:

In two nationwide epidemiological studies the prevalence of eating disorders among female high school (n = 2,028) and university students (n = 1,020) was examined using DSM-IV criteria. We used a two-stage design, administering a questionnaire in the first stage and an interview in the second stage.

Results:

In the combined samples 118 cases of eating disorders (DSM-IV) were detected, of which 86 were diagnosed as EDNOS (72.9%). Application of the DSM-5 criteria reduced the number of EDNOS cases to 60 (50.8%) or to 52 (44%), when using a BMI <18.5 as cutoff for “significantly low weight” criterion in AN; with the use of BCD-ED criteria, only 5 (4.2%) cases of EDNOS remained.

Discussion:

Proposed criteria set for DSM-5 substantially reduce the number of EDNOS cases. However, the BCD-ED scheme further reduces its proportion, almost eliminating it. © 2012 by Wiley Periodicals, Inc. (Int J Eat Disord 2013)

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