Epidemiology, course, and outcome of eating disorders.
OBJECTIVE
To review the recent literature about the epidemiology, course, and outcome of eating disorders in accordance with the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).


RESULTS
The residual category 'eating disorder not otherwise specified' (EDNOS) was the most common DSM-IV eating disorder diagnosis in both clinical and community samples. Several studies have confirmed that the DSM-5 criteria for eating disorders effectively reduce the proportion of EDNOS diagnoses. The lifetime prevalence of DSM-5 anorexia nervosa among women might be up to 4%, and of bulimia nervosa 2%. In a cross-national survey, the average lifetime prevalence of binge eating disorder (BED) was 2%. Both anorexia nervosa and bulimia nervosa are associated with increased mortality. Data on long-term outcome, including mortality, are limited for BED. Follow-up studies of BED are scarce; remission rates in randomized controlled trials ranged from 19 to 65% across studies. On a community level, 5-year recovery rates for DSM-5 anorexia nervosa and bulimia nervosa are 69 and 55%, respectively; little is known about the course and outcome of BED in the community.


CONCLUSIONS
Applying the DSM-5 criteria effectively reduces the frequency of the residual diagnosis EDNOS, by lowering the threshold for anorexia nervosa and bulimia nervosa, and adding BED as a specified eating disorder. Course and outcome studies of both anorexia nervosa and bulimia nervosa show that no significant differences exist between DSM-5 and DSM-IV definitions.
aParnassia Psychiatric Institute, The Hague bDepartment of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands cDepartment of Epidemiology, Columbia University, Mailman School of Public Health, New York, New York, USA.
Frédérique R E
FR
Smink
Daphne
D
van Hoeken
Hans W
HW
Hoek
D000856:Anorexia Nervosa / Q000175:diagnosis / Q000453:epidemiology; D056912:Binge-Eating Disorder / Q000175:diagnosis / Q000453:epidemiology; D052018:Bulimia Nervosa / Q000175:diagnosis / Q000453:epidemiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D001068:Feeding and Eating Disorders / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D015995:Prevalence