The eating disorders spectrum of DSM-III-R. Clinical features and psychosocial concomitants of 86 consecutive cases from a Swedish urban catchment area.

The diagnostic spectrum of eating disorders according to DSM-III-R was examined in a sample of 86 consecutive cases from a defined urban catchment area of Stockholm, Sweden. Presenting diagnoses were: bulimia nervosa 65%; atypical eating disorders, 20%; anorexia nervosa, restricting subtype, 9%; and, anorexia nervosa, bulimic subtype, 6%. All groups showed an extreme fear of weight gain. Restricting anorexics were older, had the latest age of onset of eating disorder, and had the shortest duration of illness. Bulimic anorexics had the longest duration of illness, earliest age of onset, and greater eating disorder psychopathology than restricting anorexics and atypicals. Bulimics exhibited significantly greater eating disorder psychopathology compared with atypicals. Both bulimics and bulimic anorexics presented with significantly greater general psychopathology compared with restricting anorexics and atypicals. Atypicals appeared to be the least disturbed group, whereas bulimic anorexics were the most disturbed. Results are discussed in terms of the relative merits of DSM-III and DSM-III-R, the characteristics of particular disorders, and the possibility of an underlying sequential course of illness in the eating disorders.