Alternativas de clasificación de los trastornos de la conducta alimentariaestudio de una muestra clínica procedente de una unidad específica ambulatoria

Abstract

Background: Eating Disorders (ED) are clinical entities that cause much interest among the population. With the publication of DSM-5, the classification of ED has been revised. Although data about psychological features support the current categorization schemes, other works have found an important overlap among these problems. The aim of this study was to investigate whether the current classification of ED was satisfactory to classify these problems. Methods: 98 patients diagnosed with AN and BN were assessed in measures of eating psychopathology, personality traits, familiar environment, general symptoms and other clinical indices. The investigation was divided in five studies. Every one of them showed different forms of grouping ED. Some multivariate analysis of variance and two exploratory hierarchical cluster analysis were performed. Results: No one of the studied models could be confirmed. Those models in which the current diagnostic manuals are based on were only partially appropriate to classify the subjects. The cluster analysis showed that the patients could be divided in five groups. The ANR was the best represented. All the clusters shared a common cognitive core of psychopathology. The other symptoms could be grouped in three general dimensions. In addition of the eating psychopathology, comorbid psychopathology, personality traits and neurobiological findings were decisive dimensions to classify the subjects. Conclusions: The current searching emphasizes the validity of the ED classification schemes that incorporate dimensions in the definition of these problems. Our results point out that a perspective like that could capture more properly the essence of these disorders.