Other Specified Feeding or Eating Disorders (OSFED): Clinical heterogeneity and cognitive-behavioral therapy outcome

Eur Psychiatry. 2018 Oct:54:109-116. doi: 10.1016/j.eurpsy.2018.08.001. Epub 2018 Sep 5.


Background: with the DSM-5 new eating disorders (EDs) diagnostic subtypes were identified within the Other Specified Feeding or Eating Disorders (OSFED) category, which have so far been under-researched. Objectives of this study were to examine differential features among OSFED subtypes, exploring short-term cognitive-behavioral therapy (CBT) response and identifying clinical predictors of therapy outcome.

Methods: the sample included 176 female patients diagnosed with OSFED [82 atypical anorexia nervosa (atypical-AN), 57 purging disorder (PD), and 37 subthreshold bulimia nervosa (sub-BN)]. Assessment included eating-related, psychopathological and personality measures.

Results: results showed similar clinical and personality profiles between the diagnostic subtypes, with hardly any differences, only observable in the core symptoms of each diagnosis. The sub-BN group was the one which showed more social impairment. Regarding treatment outcome, the three groups did not reveal significant differences in remission rates, therapeutic adherence or dropout rates, reaching rates of dropout from 36.8% to 50% (p = .391). However, different ED subtype predictors appear related with full remission or dropout risk, specifically personality traits.

Conclusions: our results suggest that OSFED patients may benefit similarly from the same CBT outpatient group approach. However, high dropout rates and low motivation seems to be an important limitation and challenge for future approaches.

Keywords: Atypical anorexia nervosa (atypical-AN); Cognitive-behavioral therapy (CBT); Other Specified Feeding or Eating Disorders (OSFED); Purging disorder (PD); Subthreshold bulimia nervosa (sub-BN); Treatment outcome.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Ambulatory Care
  • Anorexia Nervosa / psychology*
  • Anorexia Nervosa / therapy
  • Bulimia Nervosa / psychology*
  • Bulimia Nervosa / therapy
  • Cognitive Behavioral Therapy
  • Diagnostic and Statistical Manual of Mental Disorders
  • Feeding and Eating Disorders / psychology
  • Feeding and Eating Disorders / therapy
  • Female
  • Humans
  • Personality*
  • Psychotherapy, Group
  • Remission Induction
  • Treatment Outcome
  • Young Adult