An Investigation of the Clinical Utility of the Proposed ICD-11 and DSM-5 Diagnostic Schemes for Eating Disorders Characterized by Recurrent Binge Eating in People with a High BMI.

Angélica Claudino,Marly Amorim Palavras,Phillipa Hay

doi:10.3390/nu10111751

Angélica Claudino, Marly Amorim Palavras + Show 1 more

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https://doi.org/10.3390/nu10111751

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Abstract

The aims of this paper were to compare (1) the proportion of participants diagnosed with threshold or subthreshold Bulimia Nervosa (BN) and Binge Eating Disorder (BED) (clinical utility), and (2) the severity of participants’ clinical features and mental Health-Related Quality of Life (HRQoL) (convergent validity), when diagnosed according to either the Diagnostic and Statistical Manual of Mental Disorders—5th edition (DSM-5) or the proposed International Classification of Diseases 11th edition (ICD-11) schemes. One hundred and seven adult men and women, with a high Body Mass Index (BMI) were evaluated by interview to confirm their eating disorder diagnoses. All participants completed self-report assessments of current symptoms and mental HRQoL. The majority of participants in either diagnostic scheme were included in the main categories of BN or BED (102/107, 95% in the ICD-11 and 85/107, 79% in the DSM-5). Fewer individuals received a subthreshold other or unspecified diagnosis with the ICD-11 compared to the DSM-5 scheme (5% vs. 21%). No significant differences in demographic, clinical features or mental HRQoL of participants with complete or partial BN or BED were found between diagnostic categories. Compared to the DSM-5, the proposed ICD-11 was not over inclusive, i.e., it did not appear to include people with less severe and potentially less clinically relevant symptoms. These results support the greater clinical utility of the ICD-11 whilst both schemes showed convergent validity.

Highlights

IntroductionTwo diagnostic classification systems guide the field of mental disorders, the Diagnostic and Statistical Manual of Mental Disorders in its 5th edition (DSM-5) [1] and the International
Two diagnostic classification systems guide the field of mental disorders, the Diagnostic and Statistical Manual of Mental Disorders in its 5th edition (DSM-5) [1] and the InternationalClassification of Diseases, in its 10th edition (ICD-10) [2]
A final limitation is that the present study reports on a secondary analysis of data from a randomized controlled trial (RCT) testing the efficacy of psychological interventions for overweight people with bulimic disorders and used an Eating Disorder Examination (EDE) version, which does not collect the distress criterion across both OBEs and SBEs

Summary

Introduction

Two diagnostic classification systems guide the field of mental disorders, the Diagnostic and Statistical Manual of Mental Disorders in its 5th edition (DSM-5) [1] and the International. Classification of Diseases, in its 10th edition (ICD-10) [2]. 4887 psychiatrists in 44 countries indicated that 79.2% of the sample often or almost always/always used one of these formal classification systems as part of their day-to-day clinical work [5]. The DSM-5, which covers mental health exclusively, is very commonly used in the United States, United Kingdom, Australasia, and in international research. The ICD-10 is more extensive, as it includes all medical diagnoses, and it is the official government classification scheme in the majority of countries worldwide [2,5]. The two schemes differ substantively in their structure, definitions and Nutrients 2018, 10, 1751; doi:10.3390/nu10111751 www.mdpi.com/journal/nutrients

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