Diagnostic crossover in anorexia nervosa and bulimia nervosa: Implications for DSM-V
Diagnostic crossover in anorexia nervosa and bulimia nervosa: Implications for DSM-V
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DOI：
10.1176/appi.ajp.2007.07060951
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发表时间：
2008-02-01
影响因子：
17.7
通讯作者：
Herzog, David B.
中科院分区：
文献类型：
--
作者：
Eddy, Kamryn T.;Dorer, David. L.;Herzog, David B.
目的：《精神疾病诊断与统计手册》（DSM）主要是作为临床工具而设计的。然而，神经性厌食症亚型和神经性贪食症亚型之间的高诊断“交叉”率可能反映了当前诊断模式的有效性问题，从而限制了其临床实用性。本研究的目的是检查诊断交叉纵向神经性厌食症和神经性贪食症，以告知DSM-IV-TR进食障碍分类system.Method的有效性：共216名妇女与神经性厌食症或神经性贪食症的诊断进行了为期7年的随访;每周进食障碍症状数据收集使用进食障碍纵向间隔跟随-Up Examination允许在整个随访期间进行诊断。结果：7年多来，大多数神经性厌食症女性经历了诊断交叉：超过一半的神经性厌食症亚型随着时间的推移在限制和暴饮暴食/清除之间交叉;三分之一的人转变为神经性贪食症，但很可能复发为神经性厌食症。妇女与贪食神经性厌食症是不太可能交叉到anorexia nervosa.Conclusions：这些研究结果支持神经性厌食症和贪食神经性厌食症的纵向区别，但不支持神经性厌食症亚型图式。
Objective: The Diagnostic and Statistical Manual of Mental Disorders (DSM) is designed primarily as a clinical tool. Yet high rates of diagnostic "crossover" among the anorexia nervosa subtypes and bulimia nervosa may reflect problems with the validity of the current diagnostic schema, thereby limiting its clinical utility. This study was designed to examine diagnostic crossover longitudinally in anorexia nervosa and bulimia nervosa to inform the validity of the DSM-IV-TR eating disorders classification system.Method: A total of 216 women with a diagnosis of anorexia nervosa or bulimia nervosa were followed for 7 years; weekly eating disorder symptom data collected using the Eating Disorder Longitudinal interval Follow-Up Examination allowed for diagnoses to be made throughout the follow-up period.Results: Over 7 years, the majority of women with anorexia nervosa experienced diagnostic crossover: more than half crossed between the restricting and binge eating/purging anorexia nervosa subtypes over time; one-third crossed over to bulimia nervosa but were likely to relapse into anorexia nervosa. Women with bulimia nervosa were unlikely to cross over to anorexia nervosa.Conclusions: These findings support the longitudinal distinction of anorexia nervosa and bulimia nervosa but do not support the anorexia nervosa subtyping schema.