Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia.
J Abnorm Psychol. 2013 Aug;122(3):720-32. doi: 10.1037/a0034004.
The current study aimed to compare the prevalence, stability, and psychosocial correlates of DSM-IV-TR and DSM-5 eating disorders, in a population-based sample of male and female adolescents followed prospectively from 14 to 20 years of age. Participants (N = 1,383; 49% male) were drawn from the Western Australian Pregnancy Cohort (Raine) Study, a prospective, population-based cohort study that has followed participants from prebirth to young adulthood. Detailed self-report questionnaires were used to assess eating disorder symptoms when participants were aged 14, 17, and 20 years. Comparisons between DSM-IV-TR and DSM-5 were conducted using McNemar chi-square tests and Fisher's exact tests. Changes in eating disorder prevalence over time were considered using generalized estimating equations. Eating disorder prevalence rates were significantly greater when using DSM-5 than DSM-IV-TR criteria, at all time points for females and at age 17 only for males. "Unspecified"/"other" eating disorder diagnoses were significantly less common when applying DSM-5 than DSM-IV-TR criteria, but still formed 15% to 30% of the DSM-5 cases. Diagnostic stability was low for all disorders, and DSM-5 binge eating disorder or purging disorder in early adolescence predicted DSM-5 bulimia nervosa in later adolescence. Cross-over from binge eating disorder to bulimia nervosa was particularly high. Regardless of the diagnostic classification system used, all eating disorder diagnoses were associated with depressive symptoms and poor mental health quality of life. These results provide further support for the clinical utility of DSM-5 eating disorder criteria, and for the significance of binge eating disorder and purging disorder.
本研究旨在比较 DSM-IV-TR 和 DSM-5 进食障碍在男性和女性青少年人群中的流行率、稳定性和心理社会相关性，这些青少年在 14 至 20 岁期间进行了前瞻性随访。参与者（N=1383；49%为男性）来自西澳大利亚妊娠队列（Raine）研究，这是一项前瞻性、基于人群的队列研究，对参与者从产前到成年早期进行了随访。当参与者 14、17 和 20 岁时，使用详细的自我报告问卷评估进食障碍症状。使用 McNemar 卡方检验和 Fisher 确切检验比较 DSM-IV-TR 和 DSM-5。使用广义估计方程考虑进食障碍流行率随时间的变化。在所有女性参与者的所有时间点和仅在男性 17 岁时，使用 DSM-5 标准比 DSM-IV-TR 标准时进食障碍的流行率显著更高。与 DSM-IV-TR 标准相比，应用 DSM-5 标准时，“未特指”/“其他”进食障碍诊断明显较少，但仍占 DSM-5 病例的 15%至 30%。所有障碍的诊断稳定性都较低，青春期早期的 DSM-5 暴食障碍或清除障碍预测青春期后期的 DSM-5 贪食症。从暴食障碍到贪食症的交叉很高。无论使用哪种诊断分类系统，所有进食障碍诊断都与抑郁症状和心理健康生活质量差相关。这些结果进一步支持 DSM-5 进食障碍标准的临床实用性，以及暴食障碍和清除障碍的重要性。
