Differences in DSM-III-R and DSM-IV diagnoses in eating disorder patients

Suzanne R. Sunday, Carol B. Peterson, Karen Andreyka, Scott J. Crow, James E. Mitchell, Katherine A. Halmi

Research output: Contribution to journalArticlepeer-review

22 Scopus citations


Two hundred eighty-eight eating disorder patients were administered the DSM-III-R Structured Clinical Interview (SCID) and the DSM-IV SCID for axis I and II. Concordance between DSM-III-R and DSM-IV was excellent for the axis I affective and anxiety disorders, bulimia nervosa, and substance abuse/dependence. It was also excellent for axis II paranoid, schizoid, borderline, and antisocial personality disorders. Agreement between the two nosological systems was lower for alcohol abuse/dependence with a kappa of .63. Kappas were also poor for the following personality disorders: schizotypal (.44), histrionic (.29), dependent (.54), obsessive-compulsive (.62) and not otherwise specified (.63). There was a s0ubstantial difference in the diagnosis of anorexia nervosa between DSM-III-R and DSM-IV. Fourteen patients were diagnosed with anorexia nervosa, binge/purge type, using DSM-IV criteria, while only six received the diagnoses of anorexia nervosa and bulimia nervosa using DSM-III-R criteria. Kappa was .49 and the percent agreement was 79%. While there are considerable areas of overlap in DSM-IV and DSM-III-R, there are also areas of substantial differences. Clinicians and researchers must be very cautious when attempting to compare data from the different nosologies.

Original languageEnglish (US)
Pages (from-to)448-455
Number of pages8
JournalComprehensive Psychiatry
Issue number6
StatePublished - 2001

Bibliographical note

Funding Information:
From the New York Presbyterian Hospital—Weill Medical College of Cornell University, White Plains, NY; Department of Psychiatry, University of Minnesota, Minneapolis, MN; Neuropsychiatric Research Institute and University of North Dakota, Fargo, ND. Supported by The McKnight Foundation, The New York Community Trust established by DeWitt-Wallace, and the Minnesota Obesity Center Grant No. P30DK50456 from the National Institute of Health. Presented in part at the annual meeting of the Eating Disorder Research Society, November 21, 1997, Albuquerque, NM. Address reprint requests to Suzanne R. Sunday, PhD, Weill Medical College at Cornell University, 21 Bloomingdale Rd, White Plains, NY 10605. Copyright © 2001 by W.B. Saunders Company 0010-440X/01/4206-0005$35.00/0 doi:10.1053/comp.2001.27896


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