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Browsing by Subject "DSM-5"

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  • Lehtokari, Vilma-Lotta (2015)
    Eating disorders are a group of psychiatric disorders characterized by disturbances in eating behaviors, attitudes towards food, and body image. The diagnoses of eating disorders are based on specific diagnostic criteria agreed upon by expert committees. The disorders and the diagnostic criteria are collected in diagnostic manuals. In this study, the Diagnostic and Statistical research Manual of Mental Disorders (DSM) of American Psychiatric Association was used because it is used consistently in international research into eating disorders. The current Fifth Edition of the DSM (DSM-5).was published in 2013. The previous edition was published in 1994 (DSM-IV). The eating disorders specified in DSM-IV were anorexia nervosa (AN) and bulimia nervosa (BN). The remaining disorders were categorized as Eating Disorders Not Otherwise Specified (EDNOS). EDNOS consists of binge eating disorder (BED), atypical anorexia (A-AN) and atypical bulimia (A-BN). In the updated edition, DSM-5, BED has been recognized as its own separate eating disorder, and the diagnostic criteria of AN, and BN has been revised and broadened. Those eating disorders that still remain outside these definitions are classified as Other Specified Feeding and Eating Disorders (OSFED). OSFED eating disorders are A-AN, A-BN, A-BED, purging disorder (PD) and night eating disorder. The objective of this thesis was to survey and identify atypical eating disorders among Finnish young women in the FinnTwin16-cohort, and to find out how the changes in the diagnostic criteria of the DSM affects this group of eating disorders. The FinnTwin16-cohort includes all Finnish twins born in 1975-1979. The health and well-being of the twins has been followed regularly since the age of 16 using questionnaires and interviews. The questionnaire for mental disorders, including the eating disorders was sent to the twins in 1998.The eating disorder survey focused on women. Of the female twins, 2835 returned the forms, and 548 of them were subsequently interviewed over the telephone for a more detailed picture of the person’s eating disorder. According to the survey, 185 of the women had an eating disorder. Using the diagnostic criteria of DSM-IV, 55 had AN, and 46 BN. The remaining 84 women were diagnosed as having EDNOS. The EDNOS cases were re-classified using the DSM-5 diagnostic criteria, whereby 31 of them were diagnosed with AN, 14 with BN, and one with BED. An OSFED diagnosis was established in 38 women. With the change of diagnostic criteria, the prevalence of atypical eating disorders fell from 3 % to 1.3%, and the 15-year incidence from 180 to 76 new cases per 100 000 person-years. The OSFED cases were sub-categorized as follows: 13 women had A-AN, ten A-BN, four PD 4, and five A-BED. Seven women were classified as having fluctuating OSFED: symptoms that either transformed from one subtype to another or alternated with asymptomatic periods. One patient first had A–BN, and after recovering, years later, A-AN. Night eating disorder was not assessed in this study. A-AN, or PD were more transient than other types of EDNOS: no one had an eating disorder for longer than five years. These groups also included the most underweight patients. Seventy-six percent of the women studied were of normal weight. A-BED, and fluctuating OSFED were longest in duration. The weight of the women in these groups continued to increase. Depression was linked to chronic, long-term OSFEDs and binge eating, whereas life crises lead to more severe but transient forms of OSFED.