Diagnosis Eating Disorders By ICD 10 or DSM IV

The ‘Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition’ (more commonly referred to as DSM-IV) published by the American Psychiatric Association. DSM-IV groups ‘mental disorders’ into ‘Major Classifications’ such as Schizophrenia and other Psychotic disorders, Anxiety Disorders and so on with each Major Classification having a numeric code. Eating Disorders constitutes a Major Classification and is coded 307. Major Classifications are further subdivided giving a code for individual disorders in the form of xxx.xx.

The International Statistical Classification of Diseases and Related Health Problems, tenth revision – ICD-10. Published by the World Health Organisation and often used in Europe. The list of ICD-10 codes for eating disorders reads :~ F50.0 Anorexia nervosa, F50.1 Atypical anorexia nervosa, F50.2 Bulimia nervosa, F50.3 Atypical bulimia nervosa, F50.4 Overeating associated with other psychological disturbances, F50.5 Vomiting associated with other psychological disturbances, F50.8 Other eating disorders, F50.9 Eating disorder, unspecified.

Some of the codes from these two systems for specific eating disorders can be seen in the table below.

Eating Disorders F50
Anorexia Nervosa 307.1 F50.0

DSM-IV defines two subtypes of anorexia nervosa

  1. Atypical Anorexia Nervosa F50.1 (1) a restricting type which is characterised by strict dieting and exercise but without binge eating
  2. Bulimia Nervosa 307.51 , 50.2

DSM-IV defines two subtypes of Bulimia nervosa

  1. Purging type involving self-induced vomiting or the misuse of laxatives, diuretics, or enemas.
  2. Non-Purging type whereby the sufferer uses other inappropriate compensatory behaviours, including fasting or excessive exercise, but does not regularly engage in techniques used in Purging type bulimia.

Atypical Bulimia Nervosa

*F50.3 Overeating associated with other psychological disturbances 

* F50.4¹ (2) a binge-eating & purging type, marked by episodes of compulsive eating with or without self-induced vomiting and the use of laxatives or enemas.

Overeating due to stressful events.
Psychogenic³ overeating

Vomiting associated with other psychological disturbances 

* F50.5 Psychogenic³ vomiting

Other eating disorders 

  • Pica in adults
  • ² F50.8 Psychogenic
  • ³ loss of appetite

Eating Disorders Not Otherwise Specified

  • 307.50 Eating Disorders Unspecified
  • F50.9 (Binge Eating Disorder)*

Research Criteria

  • EDNOS under DSM-IV.
  • ¹ Possibly comparable to DSM-IV’s research criteria for Binge Eating Disorder.
  • ² May be considered an ENDOS under DSM-IV
  • ³ Psychogenic – Having a psychological rather than physiological origin.

Notice how a diagnosis may vary depending on the system used and also how the range of eating disorders varies between systems. For example someone with bulimic like symptoms may, depending on the the system used and the variety and/or frequency of other symptoms, be diagnosed as having:

Bulimia Nervosa ; ICD-10
Bulimia Nervosa Purging Type : DSM-IV
Bulimia Nervosa Non-Purging Type : DSM-IV
Atypical Bulimia Nervosa; ICD-10
Eating Disorder Not Otherwise Specified : DSM-IV (depending on the frequency and volume of binges)
Eating Disorder Unspecified ; ICD-10
Anorexia Nervosa -Binge Eating and Purging Type ; DSM-IV (if criteria for anorexia nervosa are also meet

 

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