Instability of eating disorder diagnoses: prospective study

• Published in: British journal of psychiatry 2005-12, Vol.187 (6), p.573-578
• Main Authors: Milos, Gabriella, Spindler, Anja, Schnyder, Ulrich, Fairburn, Christopher G.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age; Anorexia; Anorexia Nervosa - diagnosis; Anorexia Nervosa - therapy; Body mass index; Bulimia; Bulimia nervosa; Bulimia Nervosa - diagnosis; Bulimia Nervosa - therapy; Cathartics - therapeutic use; Cooperation; Diagnosis; Diagnostic Errors; Eating disorders; Feeding and Eating Disorders - diagnosis; Feeding and Eating Disorders - therapy; Female; Humans; Medical diagnosis; Middle Aged; Neurosciences; Patients; Prospective Studies; Psychiatry; Psychological processes; Psychopathology; Psychotherapy - methods; Remission; Remission (Medicine); Remission Induction; Scholarships & fellowships; Self help; Support groups; Time Factors; Treatment Outcome; Vomiting - complications; Women
• ISSN: 0007-1250; 1472-1465
• DOI: 10.1192/bjp.187.6.573

The stability of eating disorder diagnoses has received little research attention. To examine the course of the full range of clinical eating disorders. A sample of 192 women with a current DSM-IV eating disorder (55 with anorexia nervosa,108 with bulimia nervosa and 29 with eating disorder not otherwise specified) were assessed three times over 30 months using a standardised interview. Although the overarching category of "eating disorder" was relatively stable, the stability of the three specific eating disorder diagnoses was low, with just a third of participants retaining their original diagnosis. This was due only in part to remission since the remission rate was low across all three diagnoses. There is considerable diagnostic flux within the eating disorders but a low overall remission rate. This suggests that underpinning their psychopathology may be common biological and psychological causal and maintaining processes.