The diagnosis of bulimia nervosa

Abstract

The interpretation of research into the eating disorder bulimia nervosa is complicated by the use of two different sets of diagnostic criteria. In North America the DSM III criteria are usually employed (American Psychiatric Association, 1980), whereas in Britain Russell's criteria (Russell, 1979) are preferred. While the two sets of criteria appear to be designed to identify people with essentially the same disorder, they embrace different, but over-lapping, populations. Discrepancies between the findings of various investigations may therefore be attributed in part to the fact that different patient groups have been studied. In this paper both these sets of diagnostic criteria and the proposed DSM III R criteria (American Psychiatric Association, 1985) are reviewed in the light of current knowledge. In addition, the relationship between bulimia nervosa and anorexia nervosa is examined. Certain revisions to the diagnostic criteria for both disorders are suggested reflecting the view that extreme concerns about shape and weight are a central psychopathological feature uniting anorexia nervosa and bulimia nervosa.