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

Abstract

BackgroundLittle 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.MethodsIn 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.ResultsThe 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.ConclusionsEating 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.

Prevalence, features and health impacts of eating disorders amongst First-Australian Yiramarang (adolescents) and in comparison with other Australian adolescents

“…The EveryBODY study is a longitudinal investigation of eating disorders among Australian adolescents. Sampling procedures have been detailed elsewhere [5,14]. In brief, four independent and nine government schools, from a broad range of socioeconomic advantage, participated.…”

“…The operationalisation of the eating disorder diagnoses that were assessed in this study has been published previously [5], and an adapted Table of this operationalisation is included in the Supplementary material. Diagnoses assessed included the three major eating disorders (anorexia nervosa, bulimia nervosa, binge eating disorder), the five Other Specified Feeding and Eating Disorders (OSFED; atypical anorexia nervosa, subthreshold bulimia nervosa, subthreshold binge eating disorder, purging disorder, night eating syndrome) and Unspecified Feeding and Eating Disorder (UFED).…”

“…Adolescence is an important developmental period characterised by a range of physical, cognitive and psychosocial changes, [3] it is also the time when eating disorders are most likely to emerge [4]. Evidence from an Australian prospective cohort study suggests that the prevalence of eating disorders amongst Australian adolescents is 6.2% for one of the three major eating disorders (i.e., anorexia nervosa, bulimia nervosa, binge eating disorder) and as high as 22.2% when including atypical and subthreshold eating disorders [5]. Yet the prevalence of eating disorders amongst First-Australian adolescents remains unknown.…”

The Role of Family Relationships in Eating Disorders in Adolescents: A Narrative Review

“…It is widely posited that adolescence represents a relevant developmental stage during which important changes in social, behavioral, and emotional-motivational functioning occur [12]. For these characteristics, researchers indicate adolescence as a developmental phase at risk for the onset of eating disorders [13,14].…”

Diabetes and disordered eating behaviours in a community-based sample of Australian adolescents

“…Eating disorders are complex mental health disorders and have one of the highest mortality and suicide rates of any mental illness [1,2]. Meta-analytical data has shown that the prevalence of disordered eating behaviours are increasing in the general population [3][4][5] and a recent study found the point prevalence of any clinical or subclinical eating disorder to be 22% in Australian adolescents [6]. Another common health problem in adolescence is diabetes, predominantly Type 1 Diabetes (T1D) [7].…”