The validity of the DSM-IV scheme for classifying bulimic eating disorders.
Hay P., Fairburn C.
OBJECTIVE: This study was designed to assess the validity of the DSM-IV scheme for classifying recurrent binge eating. METHOD: A general population sample of 250 young women with recurrent binge eating was recruited using a two-stage design. Information on their eating habits and associated psychopathology was obtained by personal interviews. Subjects were reassessed 1 year later. RESULTS: The diagnosis of bulimia nervosa had good descriptive and predictive validity. On present state features it was not possible to distinguish binge-eating disorder from the nonpurging subtype of bulimia nervosa. However, these groups differed in their outcome at 1 year. Within eating disorder not otherwise specified (EDNOS), there was a subgroup of subjects with milder symptoms which were relatively unstable over time. DISCUSSION: The findings suggest that bulimic eating disorders exist on a continuum of clinical severity, from bulimia nervosa purging type (most severe), through bulimia nervosa nonpurging type (intermediate severity), to binge-eating disorder (least severe). The data on outcome support retaining a distinction between nonpurging bulimia nervosa and binge-eating disorder.