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澳大利亚社区样本中 DSM-5 和 ICD-11 进食障碍反复发作性暴食障碍诊断分类的比较效用。

Comparative utility of the DSM-5 and ICD-11 diagnostic classifications of eating disorders of recurrent binge eating in an Australian community-based sample.

机构信息

Institute of Psychology, University of Wroclaw, Wroclaw, Poland.

Translational Health Research Institute, Western Sydney University, Sydney, New South Wales, Australia.

出版信息

Eur Eat Disord Rev. 2024 May;32(3):524-531. doi: 10.1002/erv.3068. Epub 2024 Jan 30.

Abstract

OBJECTIVE

The present study aimed to compare the estimated prevalence, sociodemographic features and impacts of Bulimia Nervosa (BN), Binge Eating Disorder (BED) and Other Specified Feeding or Eating Disorder (OSFED; BN or BED of low frequency and/or limited duration) when comparing the DSM-5 with the broader ICD-11 diagnostic criteria for size and specifiers of binge-eating episodes in a general population epidemiological sample.

METHODS

2977 individuals (1524 women and 1453 men) aged ≥15 years from randomly selected households in South Australia were interviewed in person. Participants were asked questions relating to sociodemographic features, symptoms of eating disorder pathology, physical and mental health-related quality of life (HRQoL; SF-12) and role impairment.

RESULTS

The estimated prevalence of only one diagnosis, namely BED, was lower when applying DSM-5 criteria than when applying ICD-11 criteria, largely due to the Criterion B binge-eating specifiers of the DSM-5. There were no significant differences in participants' demographic features, HRQoL, or role impairment between the comparable diagnosis of either scheme.

CONCLUSIONS

There were few differences in distribution and similar levels of health impacts when applying either diagnostic scheme in this epidemiological study. However, cases of BED may be missed when using the stricter criteria of DSM-5 in epidemiological surveys. Further studies are needed to assess the clinical utility of the DSM-5 and ICD-11 diagnostic specifiers of binge-eating.

摘要

目的

本研究旨在比较在一般人群流行病学样本中,使用 DSM-5 与更广泛的 ICD-11 诊断标准来评估神经性贪食症(BN)、暴食障碍(BED)和其他特定的进食或饮食障碍(OSFED;BN 或 BED 发作频率低且/或持续时间有限)的患病率、社会人口学特征和影响,并比较两者在暴食发作的大小和特征方面的标准。

方法

在南澳大利亚随机抽取的家庭中,对 2977 名年龄≥15 岁的个体(1524 名女性和 1453 名男性)进行了面对面访谈。受访者被问及与社会人口学特征、饮食障碍病理症状、身心健康相关的生活质量(SF-12)和角色障碍相关的问题。

结果

仅应用 DSM-5 标准时,BED 的估计患病率低于应用 ICD-11 标准,这主要是由于 DSM-5 的 Criterion B 暴食发作特征。在可比诊断方案中,参与者的人口统计学特征、生活质量或角色障碍均无显著差异。

结论

在这项流行病学研究中,应用两种诊断方案时,其分布差异较小,对健康的影响程度相似。然而,在流行病学调查中使用 DSM-5 更严格的标准可能会遗漏 BED 病例。需要进一步研究来评估 DSM-5 和 ICD-11 诊断标准中暴食发作特征的临床实用性。

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