Comparison of DSM-IV versus proposed DSM-5 diagnostic criteria for eating disorders in a Japanese sample

Eur Eat Disord Rev. 2013 Jan;21(1):8-14. doi: 10.1002/erv.2203. Epub 2012 Oct 11.


Objective: The purpose of this study was to compare the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) and the proposed Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) diagnostic criteria in terms of the number of cases of eating disorder not otherwise specified (EDNOS) and to see which diagnostic system can effectively capture variance in psychiatric symptoms in a Japanese sample.

Method: One thousand and twenty-nine women with an eating disorder (ED) participated in this study. Assessment methods included structured clinical interviews and administration of the Eating Attitudes Test and the Eating Disorder Inventory.

Results: Relaxing the diagnostic criteria for anorexia nervosa and bulimia nervosa and recognizing binge ED decreased the proportion of EDNOS (from 45.1% to 26.1%). The DSM-5 categorization of patients was better able to capture variance in psychopathology scales.

Conclusions: The proposed revisions to EDs in the DSM-5 partially reduced reliance on EDNOS. The DSM-5 may differentiate ED groups more effectively than the DSM-IV.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Anorexia Nervosa* / classification
  • Anorexia Nervosa* / epidemiology
  • Binge-Eating Disorder* / classification
  • Binge-Eating Disorder* / epidemiology
  • Bulimia Nervosa* / classification
  • Bulimia Nervosa* / epidemiology
  • Diagnostic and Statistical Manual of Mental Disorders
  • Feeding and Eating Disorders* / classification
  • Feeding and Eating Disorders* / epidemiology
  • Female
  • Humans
  • Japan / epidemiology
  • Young Adult