Yager J, Landsverk J, Edelstein C K
Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine.
Psychiatr Med. 1989;7(3):89-99.
In response to a 1982 magazine article 641 women completed self report instruments concerning their eating disorders. Simulated DSM-III and DSM-III-R diagnoses were generated from these responses. Rediagnosis of 397 DSM-III normal weight bulimics (NWB) yielded 93.7% with DSM-III-R bulimia nervosa (BN) and 6.3% with DSM-III-R anorexia nervosa with bulimic features (ANB). Rediagnosis of 30 DSM-III ANB, yielded 66.7% with DSM-III-R ANB, 13.3% with DSM-III-R BN and 20% with subdiagnostic eating disorders (SDED). Rediagnosis of 214 DSM-III SDEDs yielded 93.5% DSM-III-R SDEDs, and 6.5% DSM-III-R BNs a relatively small shift. No Eating Disorders Inventory Scale Score or eating disorders behavioral symptom differences were noted between DSM-III and DSM-III-R ANB, or between DSM-III NBW and DSM-III-R and BN in 1982 or 20 months later. Although DSM-III-R diagnostic criteria for eating disorders are more specific than those in DSM-III, our findings suggest they may ultimately make little difference clinically. Self report instruments may be useful in approximating clinical diagnoses in large surveys. They may be especially useful for syndromes such as eating disorders, in which measureable physical criteria and observable behaviors are prominent.
针对1982年一篇杂志文章，641名女性完成了关于她们饮食失调情况的自我报告工具。从这些回答中得出了模拟的《精神疾病诊断与统计手册》第三版（DSM - III）和第三版修订本（DSM - III - R）诊断结果。对397名DSM - III标准下的正常体重贪食症患者（NWB）重新诊断后，93.7%符合DSM - III - R神经性贪食症（BN），6.3%符合DSM - III - R有贪食特征的神经性厌食症（ANB）。对30名DSM - III标准下的ANB患者重新诊断后，66.7%符合DSM - III - R ANB，13.3%符合DSM - III - R BN，20%符合亚诊断性饮食失调（SDED）。对214名DSM - III标准下的SDED患者重新诊断后，93.5%符合DSM - III - R SDED，6.5%符合DSM - III - R BN，这是一个相对较小的变化。在1982年及20个月后，DSM - III和DSM - III - R标准下的ANB之间，或者DSM - III标准下的NWB与DSM - III - R标准下的BN之间，未发现饮食失调量表得分或饮食失调行为症状有差异。尽管DSM - III - R饮食失调诊断标准比DSM - III中的更具体，但我们的研究结果表明，它们最终在临床上可能差异不大。自我报告工具在大型调查中估算临床诊断可能有用。它们对于饮食失调等综合征可能特别有用，在这些综合征中，可测量的身体标准和可观察到的行为很突出。
