title: Reassessment of patients with Eating Disorders after moving from DSM-IV towards DSM-5: a retrospective study in a clinical sample.
abstract: OBJECTIVE
  To compare the relative prevalence of eating disorders moving from DSM-IV to DSM-5, and to reassess the overall medical impairment in the revised diagnostic classes.
  
  
  METHODS
  We applied DSM-5 to 206 patients (age 15-56 years) previously studied and classified according to DSM-IV. Medical impairment was classified as low, medium, or high, based on a cumulative score of clinical severity (SCS), computed as the sum of specific weights assigned to different pathological conditions and their ascertained prognostic impact.
  
  
  RESULTS
  Application of DSM-5 produced a decrease in Eating Disorders Not Otherwise Specified (EDNOS) by 17 %, an increase in anorexia (AN) by 14 % and bulimia (BN) by 2.4 %; 44.6 % of EDNOS migrated to AN, 8 % to BN, and 30.8 % was reclassified as Other Specified Feeding and Eating Disorders (OSFED). Mean SCS was higher in AN than in other diagnoses independent of classification. Differently from EDNOS, no high score was found in OSFED. BMI (OR 0.74, 95 % CI 0.56-0.98) and duration of amenorrhea >1 year (OR 6.63, 95 % CI 1.29-34.16) resulted significantly associated with the risk for medium-high SCS level in AN classified with DSM-5.
  
  
  CONCLUSIONS
  The results confirmed that DSM-5 reduces the number of EDNOS. DSM-5 seems to better represent the clinical picture in OSFED than in EDNOS. The clinical relevance of BMI and duration of amenorrhea should be considered even more now that they are no longer used as diagnostic hallmarks of AN.
authors: Eating Disorder Centre, University Hospital "Sant'Anna", Ferrara, Italy.
authors: Malvina
authors: M
authors: Gualandi
authors: CNR Institute of Clinical Physiology, Via Trieste 41, 56126, Pisa, Italy. marzia_simoni@libero.it.
authors: Marzia
authors: M
authors: Simoni
authors: Eating Disorder Centre, University Hospital "Sant'Anna", Ferrara, Italy.
authors: Emilia
authors: E
authors: Manzato
authors: Medical Department, Eating Disorder Centre, University Hospital "Sant'Anna", Ferrara, Italy.
authors: Giovanni
authors: G
authors: Scanelli
mesh_terms: D000293:Adolescent; D000328:Adult; D039721:Diagnostic and Statistical Manual of Mental Disorders; D001068:Feeding and Eating Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D055815:Young Adult
keywords: DSM-5; DSM-IV; Eating Disorders; Severity score; Somatic involvement