Addressing the EDNOS issue and improving upon the utility of DSM-IV: classifying eating disorders using symptom profiles.
OBJECTIVE
To compare the descriptive and clinical utility of two classification systems: DSM-IV eating disorder diagnoses and proposed symptom profiles. The symptom profiles are based on the presence of overvalued ideas about shape/weight, as well as combinations of three key eating disorder symptoms (e.g. body mass index (BMI) above or below threshold and the presence or absence of bingeing and purging behaviours).


METHODS
The two systems were compared on their ability to offer descriptively useful information in classifying individuals with eating disorders. In addition, we examined our system's unique contribution to clinical outcome and its relation to readiness for change.


RESULTS
Classifying individuals via symptom profiles provided information about eating disorder not otherwise specified (EDNOS), a prevalent, heterogeneous and under-researched diagnostic category. Symptom profiles outperformed the DSM-IV diagnostic system in the ability to account for variation in patients' decision to enrol in treatment, performing comparably to readiness for change.


CONCLUSIONS
Classifying individuals according to symptom profile and readiness for change appears to have more descriptive and clinical utility than the current diagnostic system.
Dunn
Erin C
EC
St. Paul's Hospital, Eating Disorders Program, Vancouver, British Columbia, Canada. edunn@providencehealth.bc.ca
Geller
Josie
J
Brown
Krista E
KE
Bates
Mollie E
ME
D000328:Adult; D015992:Body Mass Index; D039721:Diagnostic and Statistical Manual of Mental Disorders; D001068:Feeding and Eating Disorders / Q000145:classification* / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D011795:Surveys and Questionnaires