Hay P, Fairburn C
University Department of Psychiatry, University of Oxford, United Kingdom.
Int J Eat Disord. 1998 Jan;23(1):7-15. doi: 10.1002/(sici)1098-108x(199801)23:1<7::aid-eat2>3.0.co;2-q.
This study was designed to assess the validity of the DSM-IV scheme for classifying recurrent binge eating.
A general population sample of 250 young women with recurrent binge eating was recruited using a two-stage design. Information on their eating habits and associated psychopathology was obtained by personal interviews. Subjects were reassessed 1 year later.
The diagnosis of bulimia nervosa had good descriptive and predictive validity. On present state features it was not possible to distinguish binge-eating disorder from the nonpurging subtype of bulimia nervosa. However, these groups differed in their outcome at 1 year. Within eating disorder not otherwise specified (EDNOS), there was a subgroup of subjects with milder symptoms which were relatively unstable over time.
The findings suggest that bulimic eating disorders exist on a continuum of clinical severity, from bulimia nervosa purging type (most severe), through bulimia nervosa nonpurging type (intermediate severity), to binge-eating disorder (least severe). The data on outcome support retaining a distinction between nonpurging bulimia nervosa and binge-eating disorder.
本研究旨在评估《精神疾病诊断与统计手册》第四版（DSM-IV）中复发性暴饮暴食分类方案的有效性。
采用两阶段设计招募了250名有复发性暴饮暴食的年轻女性作为一般人群样本。通过个人访谈获取她们饮食习惯及相关精神病理学信息。一年后对受试者进行重新评估。
神经性贪食症的诊断具有良好的描述性和预测效度。就当前状态特征而言，无法将暴饮暴食症与神经性贪食症的非清除型亚型区分开来。然而，这些组在一年后的结果有所不同。在未另行规定的进食障碍（EDNOS）中，有一组症状较轻的受试者，其症状随时间相对不稳定。
研究结果表明，贪食性进食障碍存在临床严重程度的连续谱，从神经性贪食症清除型（最严重），到神经性贪食症非清除型（中度严重），再到暴饮暴食症（最不严重）。关于结果的数据支持保留非清除型神经性贪食症和暴饮暴食症之间的区别。
