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DSM-5 full syndrome, other specified, and unspecified eating disorders in Australian adolescents: prevalence and clinical significance

Published online by Cambridge University Press:  02 May 2019

Deborah Mitchison*
Affiliation:
Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia Department of Psychology, Macquarie University, Sydney, Australia
Jonathan Mond
Affiliation:
Centre for Rural Health, University of Tasmania, Launceston, Australia School of Medicine, Western Sydney University, Sydney, Australia
Kay Bussey
Affiliation:
Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia
Scott Griffiths
Affiliation:
School for Psychological Sciences, University of Melbourne, Sydney, Australia
Nora Trompeter
Affiliation:
Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia
Alexandra Lonergan
Affiliation:
Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia
Kathleen M. Pike
Affiliation:
Departments of Psychiatry and Epidemiology, Columbia University, New York, USA
Stuart B. Murray
Affiliation:
Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
Phillipa Hay
Affiliation:
Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
*
Author for correspondence: Deborah Mitchison, E-mail: debbie.mitchison@gmail.com

Abstract

Background

Little information is available on the prevalence of Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 eating disorders in adolescence, and eating disorders remain unique in the DSM for not systematically including a criterion for clinical significance. This study aimed to provide the first prevalence report of the full suite of DSM-5 eating disorders in adolescence, and to examine the impact of applying a criterion for clinical significance.

Methods

In total, 5191 (participation rate: 70%) Australian adolescents completed a survey measuring 1-month prevalence of eating disorder symptoms for all criterial, ‘other specified’ and unspecified eating disorders, as well as health-related quality of life and psychological distress.

Results

The point prevalence of any eating disorder was 22.2% (12.8% in boys, 32.9% in girls), and ‘other specified’ disorders (11.2%) were more common than full criterial disorders (6.2%). Probable bulimia nervosa and binge eating disorder, but not anorexia nervosa (AN), were more likely to be experienced by older adolescents. Most disorders were associated with an increased odds for being at a higher weight. The prevalence of eating disorders was reduced by 40% (to 13.6%) when a criterion for clinical significance was applied.

Conclusions

Eating disorders, particularly ‘other specified’ syndromes, are common in adolescence, and are experienced across age, weight, socioeconomic and migrant status. The merit of adding a criterion for clinical significance to the eating disorders, similar to other DSM-5 disorders, warrants consideration. At the least, screening tools should measure distress and impairment associated with eating disorder symptoms in order to capture adolescents in greatest need for intervention.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2019

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