CPG for Eating Disorders

Annex 2.7. Diagnostic Criteria for Eating DisordersICD-10 Diagnostic Criteria for Eating DisordersIn 1992 the WHO published the ICD (International Statistical Classification of Diseases andRelated Health Problems). The ICD is used worldwide for statistics on morbidity and mortality,reimbursement systems and automatic decision support in medicine. This system is designed topromote international comparison of the recollection, processing, classification and presentationof these statistics.At this moment, the classification currently in vigour is the tenth edition (ICD-10) and theWHO continues to work on it, publishing minor annual updates and bigger updates every threeyears.Anorexia nervosa (F50.0)Disorder characterised by the presence of deliberate weight loss, induced or sustained by thepatient. The disorder occurs most frequently in adolescent girls and young women, although onrare occasions it may affect adolescent boys and young men, as well as prepubertal children orolder women up to the menopause. AN constitutes an independent syndrome, in the followingsense:a) The syndrome’s clinical features are easily recognized, resulting in a reliable diagnosis witha high degree of agreement between clinicians.b) Follow-up studies have demonstrated that, amongst patients who do not recover, aconsiderable number continue to show the main characteristics of AN in a chronic form.Despite the fact that the main causes of AN remain elusive, there is growing evidence suggestingthat there are a series of sociocultural and biological factors that interact and contribute to theonset of AN, in which less specific psychological mechanisms and personality vulnerability alsotake part. The disorder is accompanied by malnutrition of varying severity, leading to endocrineand metabolic disturbances and other functional disorders. It remains uncertain whether thecharacteristic endocrine disorder is entirely due to malnutrition and the direct effect of thebehaviours that have caused it (for example, restricted dietary choice, excessive physicalexercise with metabolic balance disturbances, self-induced vomiting and laxative abuse, with theresulting electrolyte imbalances) or if other yet unknown factors are involved.Diagnostic Guidelines:All the following disturbances must be present:a) Significant weight loss (BMI