DSM-5 y los trastornos de la conducta alimentaria

Background: The DSM-5 has proposed relevant innovations in eating disorders (ED) diagnostic criteria with implications on prevalence, outcome and treatment. Objective: To describe the evidence about the proposed modifications in diagnostic criteria of ED according to DSM-5. Method: Medline/Pubmed databases were used to look for evidence on proposed changes in eating disorders by the DSM-5. Results: In anorexia nervosa (AN) the amenorrhea as a diagnostic criterion is eliminated, besides cognitive, behavioral aspects are emphasized and the present clinical subtype symptomatology during the last 3 months must be consigned. In bulimia nervosa (BN) the frequency of binge and purging episodes decreases to 1 per week and clinical subtypes are eliminated. Binge eating disorder is recognized as a specific ED. Other disorders are proposed to be included (e.g., dysmorphic muscle disorder, avoidant/restrictive food intake disorder, pica, rumination, atypical AN, sub-threshold BN, sub-threshold binge eating disorder, purging disorder and night eating syndrome). The preliminary evidence based on the DSM-5 purpose has shown a higher prevalence of AN and BN and a decreasing of ED not otherwise specified cases. Conclusions: Changes in DSM-5 involve a more precise classification of diagnostic categories from a clinical perspective and research. Nevertheless, the DSM-6 represents a challenge for the optimization of an integral scheme of categorical and dimensional approaches on ED.