title: Differences in DSM-III-R and DSM-IV diagnoses in eating disorder patients.
abstract: Two hundred eighty-eight eating disorder patients were administered the DSM-III-R Structured Clinical Interview (SCID) and the DSM-IV SCID for axis I and II. Concordance between DSM-III-R and DSM-IV was excellent for the axis I affective and anxiety disorders, bulimia nervosa, and substance abuse/dependence. It was also excellent for axis II paranoid, schizoid, borderline, and antisocial personality disorders. Agreement between the two nosological systems was lower for alcohol abuse/dependence with a kappa of.63. Kappas were also poor for the following personality disorders: schizotypal (.44), histrionic (.29), dependent (.54), obsessive-compulsive (.62) and not otherwise specified (.63). There was a substantial difference in the diagnosis of anorexia nervosa between DSM-III-R and DSM-IV. Fourteen patients were diagnosed with anorexia nervosa, binge/purge type, using DSM-IV criteria, while only six received the diagnoses of anorexia nervosa and bulimia nervosa using DSM-III-R criteria. Kappa was.49 and the percent agreement was 79%. While there are considerable areas of overlap in DSM-IV and DSM-III-R, there are also areas of substantial differences. Clinicians and researchers must be very cautious when attempting to compare data from the different nosologies.
authors.affiliation: New York Presbyterian Hospital-Weill Medical College of Cornell University, White Plains, NY 10605, USA.
authors.forename: S R
authors.initials: SR
authors.lastname: Sunday
authors.forename: C B
authors.initials: CB
authors.lastname: Peterson
authors.forename: K
authors.initials: K
authors.lastname: Andreyka
authors.forename: S J
authors.initials: SJ
authors.lastname: Crow
authors.forename: J E
authors.initials: JE
authors.lastname: Mitchell
authors.forename: K A
authors.initials: KA
authors.lastname: Halmi
mesh_terms: D000328:Adult; D015897:Comorbidity; D003627:Data Interpretation, Statistical; D001068:Feeding and Eating Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D007406:Interview, Psychological / Q000379:methods*; D010554:Personality Disorders / Q000175:diagnosis / Q000453:epidemiology