A debate on current eating disorder diagnoses in light of neurobiological findings: is it time for a spectrum model?

doi:10.1186/1471-244X-12-76

BMC Psychiatry. 2012; 12: 76.

Published online 2012 July 6. doi: 10.1186/1471-244X-12-76

PMCID: PMC3475111

A debate on current eating disorder diagnoses in light of neurobiological findings: is it time for a spectrum model?

Samantha Jane Brooks,¹ Mathias Rask-Andersen,¹ Christian Benedict,¹ and Helgi Birgir Schiöth¹

¹Department of Neuroscience, University of Uppsala, Box 593, Uppsala, Sweden

Corresponding author.

Samantha Jane Brooks: samantha.brooks/at/neuro.uu.se; Mathias Rask-Andersen: mathiasraskandersen/at/gmail.com; Christian Benedict: christian.benedict/at/neuro.uu.se; Helgi Birgir Schiöth: helgi.schioth/at/neuro.uu.se

Received November 30, 2011; Accepted May 14, 2012.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

Sixty percent of eating disorders do not meet criteria for anorexia- or bulimia nervosa, as defined by the Diagnostic and Statistical Manual version 4 (DSM-IV). Instead they are diagnosed as ‘eating disorders not otherwise specified’ (EDNOS). Discrepancies between criteria and clinical reality currently hampering eating disorder diagnoses in the DSM-IV will be addressed by the forthcoming DSM-V. However, future diagnoses for eating disorders will rely on current advances in the fields of neuroimaging and genetics for classification of symptoms that will ultimately improve treatment.

Discussion

Here we debate the classification issues, and discuss how brain imaging and genetic discoveries might be interwoven into a model of eating disorders to provide better classification and treatment. The debate concerns: a) current issues in the classification of eating disorders in the DSM-IV, b) changes proposed for DSM-V, c) neuroimaging eating disorder research and d) genetic eating disorder research.

Summary

We outline a novel evidence-based ‘impulse control’ spectrum model of eating disorders. A model of eating disorders is proposed that will aid future diagnosis of symptoms, coinciding with contemporary suggestions by clinicians and the proposed changes due to be published in the DSM-V.

Keywords: DSM, Anorexia, Bulimia, Binge-eating, Genetic, fMRI

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