Instability of eating disorder diagnoses: prospective study.

BACKGROUND: The stability of eating disorder diagnoses has received little research attention. AIMS: To examine the course of the full range of clinical eating disorders. METHOD: A sample of 192 women with a current DSM-IV eating disorder (55 with anorexia nervosa,108 with bulimia nervosa and 29 with eating disorder not otherwise specified) were assessed three times over 30 months using a standardised interview. RESULTS: Although the overarching category of "eating disorder" was relatively stable, the stability of the three specific eating disorder diagnoses was low, with just a third of participants retaining their original diagnosis. This was due only in part to remission since the remission rate was low across all three diagnoses. CONCLUSIONS: There is considerable diagnostic flux within the eating disorders but a low overall remission rate. This suggests that underpinning their psychopathology may be common biological and psychological causal and maintaining processes