DSM criteria would aid research into EDNOS, say researchers

Eating disorder not otherwise specified (EDNOS) was the most prevalent eating disorder in a recent study. The authors recommend that the provision of suggested research criteria by the DSM would promote further research into this disorder.There are few data on the prevalence of the residual DSM-IV eating disorder diagnosis EDNOS. This is concerning given that EDNOS cases account for most referrals to eating disorder clinics.With this is mind, researchers based in Australia, the US and the UK conducted a study to investigate the lifetime prevalence of eating disorders, including EDNOS, and the long-term course of these disorders, in a large community adult sample of female twins with a mean age of 35 years (n=1002).Study participants were interviewed by telephone using the Eating Disorder Examination (EDE), a measure used to assess behavioural features of eating disorders as well as dietary restraint and eating, weight and shape concerns over the previous 28 days.In order to allow assessment of lifetime disorders using DSM-IV diagnostic criteria the EDE was revised to include lifetime questions, including the age range during which the behaviour occurred.The EDE was administered an average of 14.52 years after the initial onset of the eating disorder.Nineteen women (1.9%) met full criteria for lifetime anorexia nervosa (AN) with a further 24 (2.4%) meeting the criteria for AN with the exception of amenorrhoea (partial AN). Twenty-nine women (2.9%) met full criteria for bulimia nervosa (BN) with a further six meeting full criteria for BN but also having AN. Most women with lifetime BN had the purging type.Binge-eating disorder (BED) was diagnosed in 29 women (2.9%) while 53 women (5.3%) with no history of AN, BN or BED met criteria for EDNOS-purging type (EDNOS-p).When the EDE was administered, 7% of women with lifetime AN and 7% of women with lifetime BN continued to have an eating disorder.Similarly, 10% of women with lifetime BED and 6% of women with EDNOS-p had a current eating disorder when the EDE was administered.The researchers describe the long-term course of all the women with respect to current weight, shape and eating concern, dietary restraint and BMI, commenting that each group had characteristics that differentiated it from the group of women who had never had an eating disorder.While outcomes deemed good or above were achieved by 84% of women with AN and by 76%, 69% and 89% of those with BN, BED and EDNOS-p, respectively, less than 50% of any eating disorder group was asymptomatic.The researchers conclude that provision of suggested research criteria by the DSM would be one way of promoting further research of this disorder.Reference...