Eating disorder diagnostic criteria for DSM-V

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.

Anorexia Nervosa

A. Restriction of food intake relative to caloric requirements leading to the maintenance of a body weight less than a minimally normal weight for age and height (e.g., weight loss leading to maintenance of body weight less than 85% of that expected; or failure to make expected weight gain during period of growth, leading to body weight less than 85% of that expected).

B. Intense fear of gaining weight or becoming fat, even though underweight, or persistent behavior to avoid weight gain, even though underweight.

C. Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight.

Specify current type:

Restricting Type: during the last three months, the person has not engaged in recurrent episodes of binge eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas)

Binge-Eating/Purging Type: during the last three months, the person has engaged in recurrent episodes of binge eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas)

Bulimia Nervosa

A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:

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(1) Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances

(2) A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating).

B. Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, or diuretics.

C. The binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for 3 months.

D. Self-evaluation is unduly influenced by body shape and weight.

E. The disturbance does not occur exclusively during episodes of anorexia nervosa.

Eating Disorder Not Otherwise Specified

(These aren’t actual diagnostic criteria, just a discussion of the issues around EDNOS and how it might change based on other changes in ED diagnostic criteria.)

It is recommended that Binge Eating Disorder, described in this section of DSM-IV, be recognized as an independent disorder in DSM-5. Recommended changes in the criteria for Anorexia Nervosa, Bulimia Nervosa, and for eating and feeding disorders usually beginning in childhood should also reduce the need for Eating Disorder Not Otherwise Specified.

The work group is considering whether it may be useful and appropriate to describe other eating problems (such as purging disorder–recurrent purging in the absence of binge eating, and night eating syndrome) as conditions that may be the focus of clinical attention. Measures of severity would be required, and these conditions might be listed in an Appendix of DSM-5.

If these recommendations are accepted, the examples in Eating Disorder Not Otherwise Specified will be changed accordingly.

Binge Eating Disorder

A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:

1. eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstances

2. a sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating)

B. The binge-eating episodes are associated with three (or more) of the following:

1. eating much more rapidly than normal
2. eating until feeling uncomfortably full
3. eating large amounts of food when not feeling physically hungry
4. eating alone because of being embarrassed by how much one is eating
5. feeling disgusted with oneself, depressed, or very guilty after overeating

C. Marked distress regarding binge eating is present.

D. The binge eating occurs, on average, at least once a week for three months.

E. The binge eating is not associated with the recurrent use of inappropriate compensatory behavior (i.e., purging) and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa

Source : DSM V

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