Department of Psychiatry, University of North Carolina, Chapel Hill, NC 27599-7160, USA.
Int J Eat Disord. 2012 May;45(4):531-6. doi: 10.1002/eat.20955. Epub 2011 Aug 31.
We assessed the impact of reducing the binge eating frequency and duration thresholds on the diagnostic criteria for bulimia nervosa (BN) and binge eating disorder (BED).
We estimated the lifetime population prevalence of BN and BED in 13,295 female twins from the Swedish Twin study of Adults: Genes and Environment employing a range of frequency and duration thresholds. External validation (risk to cotwin) was used to investigate empirical evidence for an optimal binge eating frequency threshold.
The lifetime prevalence estimates of BN and BED increased linearly as the frequency criterion decreased. As the required duration increased, the prevalence of BED decreased slightly. Discontinuity in cotwin risk was observed in BN between at least four times per month and at least five times per month. This model could not be fit for BED.
The proposed changes to the DSM-5 binge eating frequency and duration criteria would allow for better detection of binge eating pathology without resulting in a markedly higher lifetime prevalence of BN or BED.
我们评估了减少暴食频率和持续时间阈值对神经性贪食症（BN）和暴食障碍（BED）诊断标准的影响。
我们使用一系列频率和持续时间阈值，对来自瑞典成人双胞胎研究：基因与环境的 13295 名女性双胞胎进行了终生人口患病率估计，以评估 BN 和 BED。采用同卵双生子风险（cotwin risk）进行外部验证，以调查最佳暴食频率阈值的经验证据。
BN 和 BED 的终生患病率估计值随频率标准的降低而呈线性增加。所需持续时间增加时，BED 的患病率略有下降。在至少每月四次和至少每月五次之间，BN 中观察到同卵双生子风险的不连续性。该模型不能适用于 BED。
DSM-5 暴食频率和持续时间标准的这些变化将有助于更好地检测暴食病理，而不会导致 BN 或 BED 的终生患病率明显升高。
