The comparative utility of statistically derived eating disorder clusters and DSM-IV diagnoses: relationship to symptomatology and psychiatric comorbidity at intake and follow-up.
BACKGROUND
The classification of eating disorders has been a matter of considerable debate. The present paper extends previous work and aimed to compare the utility of statistically derived clusters of eating disorders and conventional diagnoses.


METHODS
Adult female eating disorder patients who had previously been classified on the basis of cluster analysis of key diagnostic variables were examined on measures of eating disorder symptomatology and psychiatric comorbidity at intake (N=601) and subsequent follow-up after 6 and 36 months (N=349, N=322, respectively).


RESULTS
Compared to DSM-IV diagnoses, clusters demonstrated greater utility in terms of more distinct between-group differences and higher effect sizes in relation to a wide range of variables. The greater utility of clusters was in important respects due to the reallocation of EDNOS patients to more relevant alternative categories and to a greater emphasis on psychological and behavioural features of eating disorders.


CONCLUSIONS
In order to achieve a better classification of eating disorders, it will be important to place increased emphasis on common psychological features. There is a need to move away from increased use of subtypes and toward a definition of eating disorder per se.
Clinton
David
D
Division of Psychiatry, M57, Neurotec Department, Karolinska Institutet, Huddinge University Hospital, S-141 86, Sweden. David.Clinton@neurotec.ki.se
Norring
Claes
C
D000328:Adult; D016000:Cluster Analysis; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005069:Evaluation Studies as Topic; D001068:Feeding and Eating Disorders / Q000145:classification* / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data*; D013548:Sweden / Q000453:epidemiology; D009626:Terminology as Topic