DSM Revision for Anorexia Nervosa

According to the DSM-IV, the Diagnostic and Statistical Manual of Mental Disorders (fourth edition), for anorexia nervosa to be diagnosed, a menstruating female must have an absence of 3 consecutive cycles. This prevents a diagnosis in many women of childbearing age, and the length of time necessary to meet this criterion allows for significant endangerment to her health.

This criterion is not necessary for men, for obvious reasons, nor in children, middle aged and older women, and those who are pregnant or on certain hormonal drugs. It can unfairly prevent a positive diagnosis in the highest-risk demographic group and needs to be revised in order to make diagnosis easier and treatment to begin earlier. Many doctors, unfortunately, are not well versed in the signs of eating disorders and will rely on the DSM-IV to diagnose one. Therefore, the criterion mandating an absence of 3 consecutive menstrual cycles should be revised to instead be any observable disturbances in the cycle, including but not limited to amenorrhea for this long time.

This will allow earlier diagnoses in women from preteen to middle age, who have much higher incidences of anorexia nervosa, ED-NOS, and bulimia than groups that are exempt from that criterion. Early diagnosis and treatment improves the odds of full recovery with a lower chance of relapse and/or permanent health damage.

The 5th revision of the DSM is planned for 2011. This particular change is needed ASAP to prevent misdiagnosis and blocks to needed therapy in the highest risk group for AN.