In other areas, DSM-5 included a new chapter on Obsessive-Compulsive and Related Disorders that recognized two new disorders: hoarding disorder and excoriation (skin-picking) disorder. But the changes reflected what was already happening in the research and treatment communities, says Jesse Crosby, Ph.D., of the OCD Institute at McLean Hospital in Belmont, Mass.
“We have not seen any increase in new patients presenting with these disorders as we were already regularly treating these conditions,” Crosby says, adding that excoriation and hoarding were already considered related disorders or part of the OCD spectrum.
Crosby says the treatment approach has remained the same but new questionnaires and interviews have been added to reflect the new formal diagnostic categories.
DSM-5 upgraded binge-eating disorder from the appendix of DSM-IV to its own diagnostic category. Calls regarding binge-eating residential treatment to Cambridge Eating Disorder Center in Cambridge, Mass., have increased 25 percent with most inquiries involving no prior treatment history, says its founder and director Seda Ebrahimi, Ph.D. The center treats patients ages 12 and older, though some inquiries have been for patients as young as 10.
“By using the DSM-5, we are definitely seeing a reduction in the use of the eating disorder NOS category, partially because of the introduction of binge-eating disorder as a separate diagnosis,” Ebrahimi says.
Ebrahimi has observed new inquiries are coming from obese individuals looking for a weight loss program. “I think as professionals in the field of eating disorders, we should be careful not to over-diagnose and over-treat individuals who struggle with obesity and not a psychiatric condition called binge-eating disorder,” she adds.
By Janine Weisman