title: DSM-IV versus DSM-5: implementation of proposed DSM-5 criteria in a large naturalistic database.
abstract: OBJECTIVE
  Problems with the current DSM-IV eating disorder (ED) section have resulted in proposed changes toward the upcoming DSM-5 (http://www.dsm5.org/ProposedRevisions/Pages/EatingDisorders.aspx). We investigated consequences of these by implementing the proposal in a large naturalistic database.
  
  
  METHODS
  Patients were 2,584 children/adolescents and adults enrolled at specialized ED clinics in Sweden. DSM-IV diagnoses anorexia nervosa, bulimia nervosa, and "not otherwise specified" examples were compared with DSM-5 anorexia, bulimia, and binge ED, as well as atypical anorexia, subthreshold bulimia, and binge eating, purging disorder, and the residual unspecified category. Assessment methods included a semistructured diagnostic interview and self-ratings of ED and psychiatric symptoms.
  
  
  RESULTS
  We studied age-separated diagnostic distributions and explained variance in clinical variables associated with the two systems. Results showed some improvement of diagnostic specification as well as a slight increase in explained variance.
  
  
  CONCLUSIONS
  Remaining problems with the proposed changes were also highlighted, and possible further refinement is discussed.
authors.affiliation: KA¨TS, Z8:02 Karolinska University Hospital, SE-17176 Stockholm, Sweden. andreas.birgegard@ki.se
authors.forename: Andreas
authors.initials: A
authors.lastname: Birgegård
authors.forename: Claes
authors.initials: C
authors.lastname: Norring
authors.forename: David
authors.initials: D
authors.lastname: Clinton
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D016208:Databases, Factual; D039721:Diagnostic and Statistical Manual of Mental Disorders; D001068:Feeding and Eating Disorders / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013548:Sweden