Comparison of DSM-IV diagnostic criteria versus the Broad Categories for the Diagnosis of Eating Disorders scheme in a Japanese sample

• Eating Disorder Not Otherwise Specified (EDNOS) is a residual category in DSM-IV.
• Different options have been proposed to reduce the number of cases with EDNOS.
• BCD-ED decreased the proportion of EDNOS from 45.1% to 1.3% in a Japanese sample.
• BCD-ED was less able to capture variance in psychopathology scales than DSM-IV.
• BCD-ED may have problems on the categorization of patients with eating disorders.

The purposes of this study were to compare DSM-IV diagnostic criteria and the Broad Categories for the Diagnosis of Eating Disorders (BCD-ED) scheme in terms of the number of cases of Eating Disorder Not Otherwise Specified (EDNOS) and to test which diagnostic tool better captures the variance of psychiatric symptoms in a Japanese sample. One thousand and twenty-nine women with an eating disorder (ED) participated in this study. Assessment methods included structured clinical interviews and administration of the Eating Attitudes Test and the Eating Disorder Inventory. The BCD-ED scheme dramatically decreased the proportion of DSM-IV EDNOS from 45.1% to 1.5%. However, the categorization of patients with the BCD-ED scheme was less able to capture the variance in psychopathology scales than the DSM-IV, suggesting that the BCD-ED scheme may differentiate ED groups less effectively than the DSM-IV. These results suggest that the BCD-ED scheme may have the potential to eliminate the use of DSM-IV EDNOS, but it may have problems capturing the variance of psychiatric symptoms.