Diagnostic Criteria for Anorexia Nervosa

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TheDiagnostic & Statistical Manual of Mental Disorders,第五版,(DSM-5) was published in 2013 by the American Psychiatric Association.它为医生和心理健康专家提供了诊断特定精神疾病的标准,特色在线娱乐城游戏:PT老虎机including anorexia nervosa.

以前的诊断手册

The previous diagnostic manual,DSM-IV(1994年出版)was problematic because as many as three-quarters of patients diagnosed with an eating disorder fell into the catchall and varied category ofEating Disorder Not Otherwise Specified (EDNOS).This made it hard for researchers and clinicians to adequately define and treat the range of patients in this group.

Changes to Anorexia in the DSM-5

The DSM-5 also merged the former categories ofEating Disordersand喂养婴儿期或幼儿期的疾病and formed the new category,,饮食失调.DSM-5试图放宽某些标准,扩大特定疾病的分类,以减少EDNOS(现在称为OSFED)组的患者数量。In terms of the criteria for anorexia nervosa,DSM-5有两个主要变化:

  1. amenorrhea (loss of a menstrual period) was eliminated as a criterion.这一点很重要,因为它使男性能够满足神经性厌食的标准。它还允许官方纳入少数女性,尽管她们体重极度下降和营养不良,但仍在继续月经。
  2. 对低体重标准进行了修订,以增加主观性和临床判断。This is also an important revision because we know thatanorexia nervosa can occur in individuals who are not what would be considered objectively low weighton a BMI chart.It allows professionals to take into account an individual's独特的生长轨迹和体重历史.

神经性厌食的DSM-5标准

A person must meet all of the current DSM criteria to be diagnosed with anorexia nervosa:

  • Restriction of food intake leading to weight loss or a failure to gain weight resulting in a"体重显著降低”对于一个人的年龄来说,sex and height.​
  • Fear of becoming fat or of gaining weight.​
  • Have a distorted view of themselves and of their condition.Examples of this might include the person thinking that he or she is overweight when they are actually underweight,or believing that they will gain weight from eating one meal.患有厌食症的人也可能会找借口或否认体重过低有问题。These thoughts are known to professionals as"distortions.""

The DSM-5 also allows professionals to specify subcategories of anorexia nervosa:

  • Restricting Type:This is a subtype that is typically associated with the stereotypical view of anorexia nervosa.The person does not regularly engage in binge eating.​
  • 暴食/清洗类型:此人经常进行暴食和清洗行为,such as self-induced vomiting and/or the misuse of laxatives or diuretics.The binge eating/purging subtype is similar to神经性贪食症;however,there is no weight-loss criterion for bulimia nervosa.正如DSM以前的版本一样,神经性厌食”trumps"bulimia nervosa,也就是说,如果一个人同时满足神经性厌食症和神经性贪食症的标准,那么神经性厌食症(暴饮暴食/净化型)就会被诊断出来。

It also allows professionals to specify if the person is in partial remission or full remission (recovery),以及明确目前疾病的严重程度,基于BMI。

For Patients Who Do Not Meet Criteria for Anorexia Nervosa

对于不符合神经性厌食完全标准的患者,,其他特定的进食障碍可能是一个适当的诊断。与神经性厌食症相比,被诊断为OSFED并不意味着一个人没有病,也不需要帮助。It is also important to note that individuals may meet criteria for different eating disorders at different times as symptoms can change.There is also not a distinct line between 特色在线娱乐城游戏:PT老虎机healthy and disordered,但中间有许多灰色。

Getting Help

Anorexia nervosa can cause a number ofserious 特色在线娱乐城游戏:PT老虎机health consequences.从神经性厌食中恢复是绝对可能的。Getting help early improves the chance of a complete and lasting recovery.If you or你认识的人受到上述部分或全部标准的影响,重要的是他们要看医生,dietician or a mental-特色在线娱乐城游戏:PT老虎机health professional for an assessment.Treatment for anorexia nervosa can occur in avariety of settings基于个人需要。

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Article Sources
  • 美国精神病学协会。(2013).精神疾病诊断与统计手册(第五版)。Washington,DC:作者。
  • Vo,梅亨Erin C.Accurso,Andrea B.Goldschmidt,还有丹尼尔·勒格兰奇。2017."The Impact of DSM-5 on Eating Disorder Diagnoses.""International Journal of Eating Disorders50 (5): 578–81.DOI:10.1002/eat.22628.