How to assess eating disorder severity in males?The DSM-5 severity index versus severity based on drive for thinness

ABSTRACT

Using a male eating disorder (ED) sample, this study assessed the clinical utility of the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) severity indices for males with anorexia nervosa (AN) and bulimia nervosa (BN) and compared it to an alternative transdiagnostic severity categorisation based on drive for thinness (DT). The participants included 143 males with an ED (60 [42.0%] AN and 83 [58.0%] BN) diagnosis, who were classified using these two severity classifications. The different severity categories were then compared based on ED symptoms, general psychopathology, and personality traits. Our results revealed that the DSM-5 “mild” and DT “low” severity categories were most prevalent in the AN and BN male patients. Clinically significant findings were strongest for the DT categorisation for both AN and BN. The current findings provide initial support for an alternative transdiagnostic DT severity classification for males that may be more clinically meaningful than the DSM-5 severity indices.

Acknowledgments

We thank the following funding bodies

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The datasets generated during and/or analysed during the current study are not publicly available due to ethical restrictions to protect the confidentiality of the participants but are available from the corresponding author on reasonable requests.

Ethics

According to the Declaration of Helsinki, the present study was approved by the Clinical Research Ethics Committee (CEIC) of Bellvitge University Hospital (Ref. PR146/14) and written and signed informed consent was obtained from all participants.

Patient consent statement

Informed consent was obtained from all individual participants included in the study.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/10640266.2023.2259682

Additional information

Funding

• Centres de Recerca de Catalunya (CERCA) Programme/Generalitat de Catalunya for institutional support - Ministerio de Economía y Competitividad (PSI2015-68701-R) and Delegación del Gobierno para el Plan Nacional sobre Drogas (2017I067).• Instituto de Salud Carlos III (ISCIII) [Fondo de Investigacion (FIS) PI14/00290 and PI17/01167].• The SLT006/17/00246 grant, funded by the Department of Health of the Generalitat de Catalunya by the call ”Acció instrumental de programes de recerca orientats en l’àmbit de la recerca i la innovació en salut”.• The FEDER funds/European Regional Development Fund (ERDF); a way to build Europe.The Biomedical Research Centre in Physiopathology of Obesity and Nutrition (Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición: CIBERObn) and Centre for Mental Health Network (Centro de Investigación Biomédica en Red de Salud Mental: CIBERSAM) are both initiatives of ISCIII). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.AGP AG is supported by a pre-doctoral Grant of Fundación Carolina and the Secretaría de Relaciones Exteriores de los Estados Unidos Mexicanos (Foreign relations secretary of the United States of Mexico).