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How to assess severity in males with eating disorders? The DSM-5 severity index versus severity based on drive for thinness

Published online by Cambridge University Press:  13 August 2021

A. Dang*
Affiliation:
Melbourne School Of Psychological Science, University of Melbourne, Melbourne, Australia
I. Krug
Affiliation:
Melbourne School Of Psychological Science, University of Melbourne, Melbourne, Australia
R. Granero
Affiliation:
Department Of Psychobiology And Methodology, Universitat Autònoma de Barcelona - UAB, Barcelona, Spain
Z. Agüera
Affiliation:
Department Of Public Health, Mental Health and Maternal-Child Nursing, School of Nursing, University of Barcelona, Barcelona, Spain Ciber Fisiopatología Obesidad Y Nutrición (ciberobn), Instituto Salud Carlos III, Barcelona, Spain
I. Sánchez
Affiliation:
Ciber Fisiopatología Obesidad Y Nutrición (ciberobn), Instituto Salud Carlos III, Barcelona, Spain Department Of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
N. Riesco
Affiliation:
Ciber Fisiopatología Obesidad Y Nutrición (ciberobn), Instituto Salud Carlos III, Barcelona, Spain Department Of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
S. Jimenez-Murcia
Affiliation:
Ciber Fisiopatología Obesidad Y Nutrición (ciberobn), Instituto Salud Carlos III, Barcelona, Spain Department Of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
F. Fernandez-Aranda
Affiliation:
Ciber Fisiopatología Obesidad Y Nutrición (ciberobn), Instituto Salud Carlos III, Barcelona, Spain Department Of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
*
*Corresponding author.

Abstract

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Introduction

The Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) introduced severity indices for Eating Disorders (ED).

Objectives

This study assessed in a male ED sample the DSM-5 severity indices for Anorexia Nervosa (AN), Bulimia Nervosa (BN) and Binge Eating Disorder (BED) and compared them to an alternative transdiagnostic drive for thinness (DT) severity category and a combined DSM-5/DT severity categorization

Methods

178 males with EDs were classified using: a.) a DT categorisation based on the EDI-2 DT subscale; b.) the DSM-5 severity categories for AN, BN and BED and c.) a combination of the DT and the DSM-5 severity categorisation. These severity classifications were then compared based on psychopathology and personality.

Results

For the DSM-5 severity indices, the “mild” category was most prevalent for AN and BN, and the “moderate to extreme” group for BED. For the EDI-2 DT severity classification, the “mild” category was overrepresented in all subtypes. For the combined DSM-5/DT categorization, the “mild combined” severity group was the most prevalent for AN, while for BN and BED the “severe/extreme” combined group was most prevalent. Clinically significant findings were strongest for the DT categorization followed by the combined DSM-5/DT approach. Almost non-significant findings were revealed for the DSM-5 severity categories for all ED subtypes. These findings were most pronounced for AN and BN and almost non-existent for BED.

Conclusions

Our findings provide support for DT as an alternative transdiagnostic severity category for EDs in males that may be more meaningful than the DSM-5 severity indices for AN and BN, but not BED.

Disclosure

No significant relationships.

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
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