Revision of ICD – status update on feeding and eating disorders
Revision of ICD – status update on feeding and eating disorders
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DOI：
10.1080/21662630.2013.742971
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发表时间：
2013-02
期刊：
影响因子：
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通讯作者：
S. Al-Adawi;Brigita Bax;R. Bryant-Waugh;A. Claudino;P. Hay;P. Monteleone;C. Norring;K. Pike;David Pilon;C. Herscovici;G. Reed;P. Rydelius;P. Sharan;C. Thiels;J. Treasure;R. Uher
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文献类型：
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作者：
S. Al-Adawi;Brigita Bax;R. Bryant-Waugh;A. Claudino;P. Hay;P. Monteleone;C. Norring;K. Pike;David Pilon;C. Herscovici;G. Reed;P. Rydelius;P. Sharan;C. Thiels;J. Treasure;R. Uher
世界卫生组织目前正在修订《国际疾病及相关健康问题分类》(ICD-10)。修订ICD精神和行为障碍分类的一个中心目标是提高其临床实用性。全球代表性、文化敏感性和相关性在所有精神障碍中都很重要，但对于促进我们对喂养和饮食障碍(FED)的理解、诊断和治疗尤其关键。本文总结了饮食障碍咨询小组(EDCG)在ICD-11中对FED诊断类别的考虑的现状，并代表了正在进行的工作。EDCG的建议是由相关研究证据提供信息的，咨询小组正在努力在临床实用性和诊断纯度之间找到平衡。EDCG的临时建议包括：(1)将先前的联邦食物类别合并为一组；(2)纳入六个主要联邦食物类别，包括神经性厌食症(AN)、神经性暴食症(BN)、异食癖、反流障碍、暴食障碍(BED)和回避性/限制性进食障碍，最后两个类别代表新的类别；(3)扩阔类别，目的是减少未指明的ED类别的使用(例如，取消闭经要求、提高体重偏低的体重指数临界值，以及更改AN的认知和行为特征，以更具文化敏感度)。根据这最后一项建议，有一点需要进一步分析，那就是关于BN和BED中暴食和通便行为的频率和严重程度，因为EDCG正在考虑减少或取消频率标准，并扩大暴食标准，将“主观的”暴饮暴食包括在内。
The World Health Organization is currently revising the International Classification of Diseases and Related Health Problems (ICD-10). A central goal for the revision of the ICD classification of mental and behavioural disorders is to improve its clinical utility. Global representation and cultural sensitivity and relevance are important across all mental disorders, but are especially critical to advancing our understanding, diagnosis and treatment of feeding and eating disorders (FED). This paper summarises the current status of the Eating Disorders Consultation Group (EDCG) considerations regarding diagnostic categories for FEDs in ICD-11 and represents work in progress. The recommendations of the EDCG are informed by relevant research evidence, and the consultation group is striving to find a balance between clinical utility and diagnostic purity. Provisional recommendations of the EDCG include: (1) merger of previous FEDs categories in one group; (2) inclusion of six main FED categories that include anorexia nervosa (AN), bulimia nervosa (BN), pica, regurgitation disorder, binge-eating disorder (BED) and avoidant/restrictive food intake disorder, the last two representing new categories; (3) broadening of categories with the aim of reducing the use of the unspecified ED category (e.g. dropping the amenorrhea requirement, increasing the body mass index cut-off for low weight and rewording the cognitive and behavioural features of AN to be more culturally-sensitive). In line with this last recommendation, one point that require further analysis pertain to frequency and severity of the binge-eating and purging behaviours in BN and BED, as the EDCG is considering reducing or eliminating the frequency criterion and broadening the binge-eating criterion to include ‘subjective’ binge episodes.