New York State Psychiatric Institute, New York, NY, USA.
Psychiatry Res. 2012 Apr 30;196(2-3):302-8. doi: 10.1016/j.psychres.2011.12.021. Epub 2012 Mar 6.
The proposed DSM-5 classification scheme for eating disorders includes both major and minor changes to the existing DSM-IV diagnostic criteria. It is not known what effect these modifications will have on the ability to make reliable diagnoses. Two studies were conducted to evaluate the short-term test-retest reliability of the proposed DSM-5 eating disorder diagnoses: anorexia nervosa, bulimia nervosa, binge eating disorder, and feeding and eating conditions not elsewhere classified. Participants completed two independent telephone interviews with research assessors (n=70 Study 1; n=55 Study 2). Fair to substantial agreements (κ=0.80 and 0.54) were observed across eating disorder diagnoses in Study 1 and Study 2, respectively. Acceptable rates of agreement were identified for the individual eating disorder diagnoses, including DSM-5 anorexia nervosa (κ's of 0.81 to 0.97), bulimia nervosa (κ=0.84), binge eating disorder (κ's of 0.75 and 0.61), and feeding and eating disorders not elsewhere classified (κ's of 0.70 and 0.46). Further, improved short-term test-retest reliability was noted when using the DSM-5, in comparison to DSM-IV, criteria for binge eating disorder. Thus, these studies found that trained interviewers can reliably diagnose eating disorders using the proposed DSM-5 criteria; however, additional data from general practice settings and community samples are needed.
拟议的 DSM-5 饮食障碍分类方案对现有 DSM-IV 诊断标准进行了重大和次要修改。目前尚不清楚这些修改将对可靠诊断的能力产生什么影响。进行了两项研究，以评估拟议的 DSM-5 饮食障碍诊断的短期重测信度：神经性厌食症、神经性贪食症、暴食障碍和未在其他地方分类的喂养和进食障碍。参与者与研究评估员进行了两次独立的电话访谈（研究 1 为 70 人，研究 2 为 55 人）。在研究 1 和研究 2 中，分别观察到饮食障碍诊断的公平到大量一致性（κ=0.80 和 0.54）。确定了个体饮食障碍诊断的可接受一致性率，包括 DSM-5 神经性厌食症（κ 值为 0.81 至 0.97）、神经性贪食症（κ=0.84）、暴食障碍（κ 值为 0.75 和 0.61）和未在其他地方分类的喂养和进食障碍（κ 值为 0.70 和 0.46）。此外，与 DSM-IV 相比，使用 DSM-5 暴食障碍标准时，短期重测信度得到了提高。因此，这些研究发现，经过培训的访谈员可以使用拟议的 DSM-5 标准可靠地诊断饮食障碍；然而，还需要来自一般实践环境和社区样本的额外数据。
