THE VALIDITY OF THE DSM-IV SCHEME FOR CLASSIFYING BULIMIC EATING DISORDERS

Objective: This study was designed to assess the validity of the DSM-I V scheme or classifying recurrent binge eating. Method: A general popu lation sample of 250 young women with recurrent binge eating was recru ited using a two-stage design. information on their eating habits and associated psychopathology was obtained by personal interviews. Subjec ts were reassessed 1 year later. Results: The diagnosis of bulimia ner vosa had good descriptive and predictive validity. On present state fe atures it was not possible to distinguish binge-eating disorder ti-om the nonpurging subtype of bulimia nervosa. However, these groups diffe red in their outcome at I year. Within eating disorder not otherwise s pecified (EDNOS), there was a subgroup of subjects with milder symptom s which were relatively unstable over time. Discussion: The findings s uggest that bulimic eating disorders exist on a continuum of clinical severity, from bulimia nervosa purging type (most severe), through bul imia nervosa nonpurging type (intermediate severity), to binge-eating disorder (least severe). The data on outcome support retaining a disti nction between nonpurging bulimia nervosa and binge-eating disorder. ( C) 1998 by John Wiley & Sons, Inc.