Revisiting Classification of Eating Disorders-toward Diagnostic and Statistical Manual of Mental Disorders-5 and International Statistical Classification of Diseases and Related Health Problems-11

Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India.
Indian Journal of Psychological Medicine 07/2012; 34(3):290-6. DOI: 10.4103/0253-7176.106041
Source: PubMed


Two of the most commonly used nosological systems- International Statistical Classification of Diseases and Related Health Problems (ICD)-10 and Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV are under revision. This process has generated a lot of interesting debates with regards to future of the current diagnostic categories. In fact, the status of categorical approach in the upcoming versions of ICD and DSM is also being debated. The current article focuses on the debate with regards to the eating disorders. The existing classification of eating disorders has been criticized for its limitations. A host of new diagnostic categories have been recommended for inclusion in the upcoming revisions. Also the structure of the existing categories has also been put under scrutiny.

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    • "Both systems have their proponents and opponents; neither system can claim superiority (Frances & Nardo, 2013; Goyal, Balhara & Khandelwal, 2012; Uher & Rutter, 2012). Their revision implies tackling the lumper/splitter problem described by Charles Darwin (Endersby, 2009; Leventhal, 2012). "
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    ABSTRACT: There is scant research on the clinical utility of differentiating International Classification of Diseases (ICD) 10 diagnoses F50.0 anorexia nervosa (typical AN) and F50.1 atypical anorexia. We reviewed systematically records of 47 adolescents who fulfilled criteria for ICD-10 F50.0 (n = 34) or F50.1 (n = 13), assessing the impact of diagnostic subtype, comorbidity, background factors and treatment choices on recovery. Atypical AN patients were significantly older (p = 0.03), heavier (minimum body mass index 16.7 vs 15.1 kg/m(2) , p = 0.003) and less prone to comorbidities (38% vs 71%, p = 0.04) and had shorter, less intensive and less costly treatments than typical AN patients. The diagnosis of typical versus atypical AN was the sole significant predictor of treatment success: recovery from atypical AN was 4.3 times (95% confidence interval [1.1, 17.5]) as likely as recovery from typical AN. Overall, our findings indicate that a broader definition of AN may dilute the prognostic value of the diagnosis, and therefore, ICD-11 should retain its distinction between typical and atypical AN. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.
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    ABSTRACT: The current nosography of eating disorders (ED) has various limitations in terms of validity and accuracy. The changes adopted in the DSM-5 limit some of the current problems, such as excessive prevalence of ED not otherwise specified (EDNOS) and the lack of longitudinal stability, but are unlikely to adequately capture the clinical complexity of ED. Many authors suggest the need for a thorough review of the current nosography to support evidence-based classification. In this paper, we discuss the validity of the current diagnostic categories and their possible reorganization. Furthermore, we review the main empirical models of classification and the diagnostic approach from a personality perspective, with particular attention to research and to the prognostic and therapeutic implications.
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    ABSTRACT: El Manual Diagnóstico y Estadístico de los Trastornos Mentales (DSM) y la Clasificación Internacional de Enfermedades (CIE) integran los criterios diagnósticos comúnmente utilizados en la práctica psiquiátrica, pero debido a que el DSM-IV-TR era insuficiente para el trabajo clínico actual, el Congreso de la Asociación Psiquiátrica Americana ha hecho público el DSM-5, que incluye modificaciones a algunos aspectos de la psiquiatría infantil, ya que muchos de los trastornos que estaban en el capítulo de alteraciones de comienzo en la infancia, la niñez y la adolescencia pasan a otros capítulos, se añaden nuevos criterios diagnósticos o se introducen nuevos términos, de modo que resulta muy importante dar a conocer a los psiquiatras que evalúan a niños los cambios en la nomenclatura y la clasificación a los que se verán enfrentados.
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