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Eating disorders, DSM–5 and clinical reality

  • Christopher G. Fairburn (a1) and Zafra Cooper (a1)
Summary

The DSM–IV scheme for classifying eating disorders is a poor reflection of clinical reality. In adults it recognises two conditions, anorexia nervosa and bulimia nervosa, yet these states are merely two presentations among many. As a consequence, at least half the cases seen in clinical practice are relegated to the residual diagnosis ‘eating disorder not otherwise specified’. The changes proposed for DSM–5 will only partially succeed in correcting this shortcoming. With DSM–6 in mind, it is clear that comprehensive transdiagnostic samples need to be studied with data collected on their current state, course and response to treatment. Only with such data will it be possible to derive an empirically based classificatory scheme that is both rooted in clinical reality and of value to clinicians.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial licence (http://creativecommons.org/licenses/by-nc/4.0/), which permits noncommercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.
Corresponding author
Christopher G. Fairburn, Oxford University Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX, UK. Email: credo@medsci.ox.ac.uk
Footnotes
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C.G.F. is a Wellcome Principal Research Fellow and Z.C. is supported by a programme grant from the Wellcome Trust (046386).

Declaration of interest

None.

Footnotes
References
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1 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorder (4th edn) (DSM–IV). American Psychiatric Association, 1994.
2 Crisp, AH. Anorexia Nervosa: Let Me Be. Academic Press, 1980.
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21 Fairburn, CG, Cooper, Z, Doll, HA, O'Connor, ME, Bohn, K, Hawker, DM, et al. Transdiagnostic cognitive-behavioral therapy for patients with eating disorders: a two-site trial with 60-week follow-up. Am J Psychiatry 2009; 166: 311–9.
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The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
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Eating disorders, DSM–5 and clinical reality

  • Christopher G. Fairburn (a1) and Zafra Cooper (a1)
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