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A systematic review and meta-analysis on the DSM-5 severity specifiers for eating disorders

Published online by Cambridge University Press:  13 August 2021

A. Dang ,
S. Giles ,
F. Fernandez-Aranda ,
L. Kiropoulos  and
M. Fuller-Tyszkiewicz
A. Dang*
Affiliation:
Melbourne School Of Psychological Science, University of Melbourne, Melbourne, Australia
S. Giles
Affiliation:
Melbourne School Of Psychological Science, University of Melbourne, Melbourne, Australia
F. Fernandez-Aranda
Affiliation:
Ciber Fisiopatología Obesidad Y Nutrición (ciberobn), Instituto Salud Carlos III, Barcelona, Spain Department Of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
L. Kiropoulos
Affiliation:
Melbourne School Of Psychological Science, University of Melbourne, Melbourne, Australia
M. Fuller-Tyszkiewicz
Affiliation:
School Of Psychology, Deakin University, Melbourne, Australia Centre For Social And Early Emotional Development, Deakin University, Burwood, Australia
*
*Corresponding author.

Abstract

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Introduction

The DSM-5 introduced severity indicies for the first time.

Objectives

We conducted a systematic review and synthesis the frequency of each DSM-5 severity categories (i.e., mild, moderate, severe and extreme severe) for Anorexia Nervosa (AN), Bulimia Nervosa (BN) and Binge Eating Disorders (BED), and to evaluate studies that assess the clinical utility of these severity specifiers for all eating disorders (ED) subtypes.

Methods

Five databases (EMBASE, MEDLINE, PsycARTICLES, PsycINFO, and ProQuest) were used to identify for both academic and grey literature published from 2013 until July 8, 2020. Twenty-five studies were retrieved for the systematic review based on the inclusion and exclusion criteria, and up to six studies were qualified for meta-analysis

Results

We found limited support for the current DSM-5 severity ratings for all ED indices, as the majority of ED severity groups were not significantly distinguishable in overall ED psychopathology (mean effect size ranged from .02 to .5). The value of the DSM-5 severity ratings was further devalued as 56.91% to 80.52% of individuals with AN, BN, and BED were categorized into mild and moderate groups. However, there was significant heterogeneity between the studies (p< .001), and some of these heterogeneities were explained by differences in study settings and measurement of eating disorder psychopathology.

Conclusions

Overall, the current study provided little support for the DSM-5 severity ratings for EDs, thus it is suggested that further exploration in alternative severity classification approach is needed.

Disclosure

No significant relationships.

Keywords

anorexia nervosaDSM-5 severity indicatorseating disordersbinge eating disorder
Type
Abstract
Information
European Psychiatry , Volume 64 , Special Issue S1: Abstracts of the 29th European Congress of Psychiatry , April 2021 , pp. S704
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
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