Comparison of DSM-IV versus proposed DSM-5 diagnostic criteria for eating disorders: reduction of eating disorder not otherwise specified and validity

Int J Eat Disord. 2011 Sep;44(6):553-60. doi: 10.1002/eat.20892. Epub 2011 Feb 14.

Abstract

Objective: Revised Eating Disorder (ED) diagnostic criteria have been proposed for the Diagnostic and Statistical Manual (DSM)-5 to reduce the preponderance of eating disorder not otherwise specified (EDNOS) and increase the validity of diagnostic groups. This article compares DSM-IV and proposed DSM-5 diagnostic criteria on number of EDNOS cases and validity.

Method: Participants (N = 397; 91% female) completed structured clinical interviews in a two-stage epidemiological study of EDs. Interviewers did not follow standard skip rules, making it possible to evaluate alternative ED diagnostic criteria.

Results: Using DSM-IV versus DSM-5 criteria, 34 (14%) versus 48 (20%) had anorexia nervosa, 43 (18%) versus 44 (18%) had bulimia nervosa, and 163 (68%) had EDNOS versus 20 (8%) had binge eating disorder (BED), and 128 (53%) had EDNOS, respectively, reflecting a significant decrease in EDNOS. Validation analyses supported significant differences among groups with some improvement associated with delineation of BED.

Discussion: Proposed revisions to EDs in the DSM-5 significantly reduced reliance on EDNOS without loss of information.

Publication types

  • Research Support, N.I.H., Extramural
  • Validation Study

MeSH terms

  • Adult
  • Diagnosis, Differential
  • Diagnostic and Statistical Manual of Mental Disorders*
  • Feeding and Eating Disorders / diagnosis*
  • Female
  • Humans
  • Interview, Psychological
  • Male
  • Middle Aged
  • Reproducibility of Results