Broad Categories for the Diagnosis of Eating Disorders (BCD-ED): An Alternative System for Classification

Objective: Eating Disorder Not Otherwise Specified (EDNOS), a residual category in DSM-IV, is the most commonly used eating disorder diagnosis in clinical settings. A diagnostic scheme, termed Broad Categories for the Diagnosis of Eating Disorders (BCD-ED), is proposed to diminish use of the EDNOS category while preserving the existing eating disorder categories. The objective of this review was to examine the advantages and disadvantages of adopting this scheme for DSM-V. Method: We reviewed published studies to assess the proportion of individuals with DSM-IV EDNOS that would be reclassified under the BCD-ED system, support for the hierarchy of the three categories, and the potential risk of over-diagnosis. Results: Adopting the BCD-ED scheme would have both advantages and disadvantages, but would likely substantially reduce the number of individuals who would receive an EDNOS diagnosis. Discussion: BCD-ED is a potential method of addressing the high frequency of EDNOS, but would be a major change in how eating disorders are categorized. (C) 2009 American Psychiatric Association.