Wilkop Madeleine, Wade Tracey D, Keegan Ella, Cohen-Woods Sarah
Discipline of Psychology, College of Education, Psychology, and Social Work, Flinders University, Adelaide, South Australia, Australia; Blackbird Initiative, Flinders University Institute for Mental Health and Wellbeing, Flinders University, Adelaide, South Australia, Australia.
Discipline of Psychology, College of Education, Psychology, and Social Work, Flinders University, Adelaide, South Australia, Australia; Blackbird Initiative, Flinders University Institute for Mental Health and Wellbeing, Flinders University, Adelaide, South Australia, Australia; Flinders Centre for Innovation in Cancer, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.
Clin Psychol Rev. 2023 Apr;101:102267. doi: 10.1016/j.cpr.2023.102267. Epub 2023 Mar 3.
Previous research revealed that people who did not meet full DSM-IV criteria for anorexia nervosa (AN), bulimia nervosa (BN), or binge-eating disorder (BED) but met criteria for eating disorder not otherwise specified (EDNOS) display high levels of psychiatric and physical morbidity commensurate with full criteria eating disorders. The DSM-5 introduced significant changes to eating disorder diagnostic criteria, so the present study aimed to determine whether the revised diagnostic criteria better distinguish between full criteria eating disorders, and other specified feeding or eating disorder (OSFED) and unspecified feeding or eating disorder (UFED). We present a series of meta-analyses comparing eating pathology, general psychopathology, and physical health impairments among those with AN, BN, and BED, compared to those with OSFED or UFED (n = 69 eligible studies). Results showed significantly more eating pathology in OSFED compared to AN, no difference in general psychopathology, and greater physical health impairments in AN. BN had greater eating pathology and general psychopathology than OSFED, but OSFED showed more physical health impairments. No differences were found between BN and purging disorder or low-frequency BN, or between BED and OSFED. Findings highlight the clinical severity of OSFED and suggest the DSM-5 criteria may not appropriately account for these presentations.
先前的研究表明，那些不符合神经性厌食症（AN）、神经性贪食症（BN）或暴饮暴食症（BED）的完整《精神疾病诊断与统计手册》第四版（DSM-IV）标准，但符合未另行规定的进食障碍（EDNOS）标准的人，其精神和身体疾病的水平与符合完整标准的进食障碍相当。《精神疾病诊断与统计手册》第五版（DSM-5）对进食障碍诊断标准进行了重大修改，因此本研究旨在确定修订后的诊断标准是否能更好地区分符合完整标准的进食障碍、其他特定的喂养或进食障碍（OSFED）以及未特定的喂养或进食障碍（UFED）。我们进行了一系列荟萃分析，比较了AN、BN和BED患者与OSFED或UFED患者（n = 69项符合条件的研究）在进食病理学、一般精神病理学和身体健康损害方面的情况。结果显示，与AN相比，OSFED的进食病理学明显更多，一般精神病理学无差异，而AN的身体健康损害更大。BN的进食病理学和一般精神病理学比OSFED更严重，但OSFED的身体健康损害更多。在BN与清除型进食障碍或低频BN之间，以及BED与OSFED之间未发现差异。研究结果突出了OSFED的临床严重性，并表明DSM-5标准可能无法适当地解释这些表现。
