Eating disorders in adolescents: how does the DSM-5 change the diagnosis?

Martin Fisher; Marisol Gonzalez; Joan Malizio

doi:10.1515/ijamh-2014-0059

Article

Eating disorders in adolescents: how does the DSM-5 change the diagnosis?

Martin Fisher , Marisol Gonzalez and Joan Malizio

Published/Copyright: January 24, 2015

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From the journal International Journal of Adolescent Medicine and Health Volume 27 Issue 4

Abstract

Purpose: This study aimed to determine the changes in diagnosis that occur in making the transition from Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria in an adolescent medicine eating disorder program.

Methods: During the months of September 2011 through December 2012, a data sheet was completed at the end of each new outpatient eating disorder evaluation listing the patient’s gender, age, ethnicity, weight, height, DSM-IV diagnosis, and proposed DSM-5 diagnosis. Distributions were calculated using the Mann-Whitney and Wilcoxon rank sum analyses to determine differences between diagnostic groups.

Results: There were 309 patients evaluated during the 16-month period. DSM-IV diagnoses were as follows: anorexia nervosa, 81 patients (26.2%); bulimia nervosa, 29 patients (9.4%); binge eating disorder, 1 patient (0.3%); and eating disorder not otherwise specified (EDNOS), 198 patients (64.6%). By contrast, DSM-5 diagnoses were as follows: anorexia nervosa, 100 patients; atypical anorexia nervosa, 93 patients; avoidant/restrictive food intake disorder, 60 patients; bulimia nervosa, 29 patients; purging disorder, 18 patients; unspecified feeding or eating disorder, 4 patients; subthreshold bulimia nervosa, 2 patients; subthreshold binge eating disorder, 2 patients; and binge eating disorder, 1 patient.

Conclusion: Almost two thirds (64.6%) of the 309 patients had a diagnosis of EDNOS based on the DSM-IV criteria. By contrast, only four patients had a diagnosis of unspecified feeding or eating disorder based on the DSM-5 criteria. These data demonstrate that the goal of providing more specific diagnoses for patients with eating disorders has been accomplished very successfully by the new DSM-5 criteria.

Keywords: adolescents; anorexia nervosa; bulimia nervosa; DSM-5; eating disorders

Corresponding author: Martin Fisher, Cohen Children’s Medical Center, Division of Adolescent Medicine, North Shore–Long Island Jewish Health System, 410 Lakeville Road, Suite 108, New Hyde Park, NY 11042, USA, Phone: +(516) 465-5459, Fax: +(516) 465-5299, E-mail: fisher@nshs.edu; and Hofstra North Shore–LIJ School of Medicine, Hempstead, NY, USA

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Article note

Presented as a Platform Presentation at the Annual Meeting of the Society for Adolescent Health and Medicine, March 2014, Austin, Texas.

Received: 2014-9-23

Accepted: 2014-11-22

Published Online: 2015-1-24

Published in Print: 2015-11-1

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Articles in the same Issue

https://doi.org/10.1515/ijamh-2014-0059

Keywords for this article

adolescents; anorexia nervosa; bulimia nervosa; DSM-5; eating disorders