![]() ![]() ![]() For example, it is noteworthy that the majority of the diagnoses change across time and a considerable number of AN patients develop BN, and vice versa. However, several data seem to indicate that the new DSM-5 criteria determine mainly quantitative changes, and some issues related to the DSM categorization of eating disorders were not solved with the new edition. 4 The new criteria adopted in the last edition of the DSM included in the main diagnoses the majority of patients who were classified as EDNOS, maintaining this category as a residual condition. The National Comorbidity Survey Replication estimates the lifetime prevalence of AN, BN, and BED at 0.9%, 1.5%, and 3.5% in women and 0.3%, 0.5%, and 2.0% in men, respectively. Conversely, by using DSM-5 criteria, many of these individuals will be returned to a diagnosis with a greater clinical utility. This “miscellaneous” category provides less clinical utility. Le Grange et al, 3 in a nationwide study in the US, reported that 80.97% of adolescents and 75.38% of adults with an eating disorder were classified as having EDNOS, making it the most common eating disorder diagnosis. 1 In reviewing and revising these disorders, the DSM-5 Eating Disorders Work Group had two objectives: clarify the existing diagnostic criteria, and decrease the frequency with which individuals, presenting for eating disorder treatment, were assigned to the heterogeneous category residual category, other specified feeding or eating disorder (or, in DSM-IV, eating disorders not otherwise specified ), reassigning someone to a specific diagnosis. ![]() Moreover, the DSM-5 officially recognized BED as a formal diagnosis. 2 In AN, the amenorrhea criterion was removed, and in BN, the threshold frequency of binge episodes and compensatory behaviors were decreased as the two subtypes (purging type and non-purging type) were deleted. 1 The modifications of the diagnostic criteria appearing in the DSM-5 are relatively few, although significant, and involve clarifications to language and adjustments to existing diagnoses. It includes anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), ARFID, rumination disorder, pica, other specified feeding or eating disorder, and unspecified feeding or eating disorder. These changes include the inclusion of three disorders – avoidant/restrictive food intake disorder (ARFID), rumination disorder, and pica – previously described in the “Feeding and Eating Disorder of Infancy or Early Childhood” chapter and subsequently removed with the aim to produce a single chapter for eating disorders in childhood and adulthood. The last version of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition ( DSM-5), 1 places eating disorders in the “Feeding and Eating Disorders” chapter, featuring several modifications of DSM-IV-TR. In particular, we focused on what is known about the symptoms, epidemiology, assessment, and diagnostic boundaries of a new problematic eating pattern called orthorexia nervosa that could be accepted as a new psychological syndrome, as emphasized by an increasing number of scientific articles in the last few years.Įating disorders have been defined as “characterized by persistence disturbance of eating or eating-related behavior that results in the altered consumption or absorption of food and that significantly impairs health or psychosocial functioning”. We also examined literature supporting the inclusion of new emergent eating behaviors within the eating disorder spectrum, and their relationship with anorexia, autism, and obsessive–compulsive disorder. In this review, the historic evolution of the eating disorder concept up to the recent Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, has been evaluated. Some of these conditions are still under investigation and are not clearly identified as independent diagnostic entities. The psychopathology of eating disorders changed across time under the influence of environmental factors, determining the emergence of new phenotypes. Eating disorders have been defined as “characterized by persistence disturbance of eating or eating-related behavior that results in the altered consumption or absorption of food and that significantly impairs health or psychosocial functioning”.
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