DSM-5 reduces the proportion of EDNOS cases: Evidence from community samples

Objective: Eating Disorder Not Otherwise
Specified (EDNOS) constitute the most common
eating disorder among those seeking
treatment at eating disorder facilities; they
are even more common among persons
with eating disorders the community. This
study compares the impact of applying the
revised diagnostic criteria proposed by the
DSM-5 workgroup, and the broad categories
for the diagnosis of eating disorders
(BCD-ED) proposed by Walsh and Sysko on
the prevalence of EDNOS.
Method: In two nationwide epidemiological
studies the prevalence of eating
disorders among female high school (n
5 2,028) and university students (n 5
1,020) was examined using DSM-IV criteria.
We used a two-stage design, administering
a questionnaire in the first stage
and an interview in the second stage.Results: In the combined samples 118
cases of eating disorders (DSM-IV) were
detected, of which 86 were diagnosed as
EDNOS (72.9%). Application of the DSM-5
criteria reduced the number of EDNOS
cases to 60 (50.8%) or to 52 (44%), when
using a BMI \18.5 as cutoff for ‘‘signifi-
cantly low weight’’ criterion in AN; with
the use of BCD-ED criteria, only 5 (4.2%)
cases of EDNOS remained.
Discussion: Proposed criteria set for
DSM-5 substantially reduce the number
of EDNOS cases. However, the BCD-ED
scheme further reduces its proportion,
almost eliminating it.
Supported by Contract grant sponsor: Fundacao para a Ciencia e a Tecnologia/Foundation for Science and Technology, Portugal; contract grant number: PTDC/PSI-PCL/099981/2008