University of Ottawa Institute of Mental Health Research, Ottawa, Canada.
Eur Eat Disord Rev. 2015 Mar;23(2):100-10. doi: 10.1002/erv.2339. Epub 2014 Dec 18.
DSM-5 changes for eating disorders (EDs) aimed to reduce preponderance of non-specified cases and increase validity of specific diagnoses. The objectives were to estimate the combined effect of changes on prevalence of EDs in adolescents and examine validity of diagnostic groupings.
A total of 3043 adolescents (1254 boys and 1789 girls, Mage = 14.19 years, SD = 1.61) completed self-report questionnaires including the Eating Disorder Diagnostic Scale.
Prevalence of full-threshold EDs increased from 1.8% (DSM-IV) to 3.7% (DSM-5), with a higher prevalence of bulimia nervosa (1.6%) and the addition of the diagnosis of purging disorder (1.4%); prevalence of binge eating disorder was unchanged (0.5%), and non-specified cases decreased from 5.1% (DSM-IV) to 3.4% (DSM-5). Validation analyses demonstrated that DSM-5 ED subgroups better captured variance in psychopathology than DSM-IV subgroups.
Findings extend results from previous prevalence and validation studies into the adolescent age range. Improved diagnostic categories should facilitate identification of EDs and indicate targeted treatments.
DSM-5 对进食障碍（EDs）的修订旨在减少非特定病例的优势，提高特定诊断的有效性。目的是估计这些变化对青少年中 ED 患病率的综合影响，并检查诊断分组的有效性。
共有 3043 名青少年（1254 名男孩和 1789 名女孩，Mage=14.19 岁，SD=1.61）完成了包括饮食障碍诊断量表在内的自我报告问卷。
全阈值 ED 的患病率从 DSM-IV 的 1.8%上升到 DSM-5 的 3.7%，其中神经性贪食症（1.6%）和清除障碍（1.4%）的患病率更高；暴食障碍的患病率保持不变（0.5%），而非特定病例从 DSM-IV 的 5.1%下降到 DSM-5 的 3.4%。验证分析表明，DSM-5 的 ED 亚组比 DSM-IV 的亚组更好地捕捉到了精神病理学的变化。
研究结果将之前的患病率和验证研究的结果扩展到了青少年年龄段。改进的诊断类别应有助于识别 ED，并指出针对性的治疗方法。
