How much difference does DSM-5 make? A longitudinal evaluation of DSM-IV and DSM-5 eating disorders in a population-based cohort of adolescents

Aims

This study aimed to provide data on the relative prevalence of DSM-IV and DSM-5 eating disorders at three time points in adolescence, for males and females. It also aimed to examine associations between DSM-IV and DSM-5 eating disorders and depressive symptoms and quality of life.

Methods

Participants (N=1,383; 49% male) were drawn from the Western Australian Pregnancy Cohort (Raine) Study, a prospective, population-based cohort study that has followed participants from pre-birth to young adulthood. Changes in eating disorder prevalence over time were considered using generalised estimating equations.

Results

Eating disorder prevalence rates increased significantly from age 14 to age 20, irrespective of the diagnostic system used. The prevalence of DSM-5 eating disorders was significantly higher than the prevalence of DSM-IV eating disorders for females, but not for males. 'Unspecified' eating disorders were significantly less common when applying DSM-5 than DSM-IV criteria, for males and females, but still accounted for 15% to 40% of the DSM-5 cases. All eating disorder diagnoses were associated with depressive symptoms and poor mental health quality of life.

Conclusions

Results provide further support for the clinical utility of DSM-5 eating disorder criteria, and for the significance of binge eating disorder and 'not elsewhere classified' disorders.

This abstract was presented in the Understanding and Treating Eating Pathology stream of the 2013 ANZAED Conference.