Field Study For ICD-11 Classification Of Feeding And Eating Disorders In China

【Objective】 To study the clinical utility of ICD-11 classification of feeding and eating disorders,including the views of the guide by mental health professionals.To compare the results of the Chinese mental health professionals with the average level and try to find out the possible differences.And to explore the latent class structure of eating disorder patients in China and the cross-cultural applicability of the ICD-11 classification of eating disorders.This study aimed to provide meaningful information for ICD revision in China.【 Methods 】 We investigated the clinical utility and the cross-cultural applicability of ICD-11 Classification of feeding and eating disorders in China from two aspects as following:1.The web-based questionnaires of ICD-11 Classification of feeding and eating disorders were sent to 353 Chinese language users in GCPN.Vignette studies were used to design related questions and Qualtrics software was used to collect datas.These data were included in the global sample.2.The clinical interview and EDI questionnaire were used to assess 379 Chinese outpatients and inpatients with eating disorders from Shanghai Mental Health Center from 2010 to 2016.SPSS 20.0 and Latent GOLD 4.5 was employed to analyze the data.【Results】1.Web-based questionnaires:(1)The comparison between ICD-11 and ICD-10 shows that both guides can effectively distinguish different vignettes,with ICD-11 performing better than ICD-10(p < 0.01,except in the sixth comparison,p < 0.05).The accuracy of ICD-11 users is better than ICD-10 in diagnosing specific cases.On multiple aspects such as the ease of use,the confidence of diagnosis and the clearance of guidelines,ICD-11 has received higher evaluations than ICD-10 from users(p < 0.001).(2)In most of the vignettes,Chinese mental health professionals have similar diagnostic accuracy as international ones.However,compared to their global counterparts,the results of Chinese users are less accurate in some specific cases.2.Latent Profile Analysis revealed five classes of eating disorder sample:low-weight fasting class(23.17%),non-fat-phobic binge/purge class(21.54%),low fat-phobic binge class(19.27%),fat-phobic binge class(19.27%),and non-fat-phobic low-weight class(16.76%).There were significant difference among the variances,including : BMI,binge eating,vomit,laxative use and fear of fat.【Conclusions】1.Compared with ICD-10,ICD-11 classification of feeding and eating disorders has distinctly improved its clinical utility.2.In general,the application of ICD-11 classification of feeding and eating disorders in Chinese mental health professionals are similar to the international ones,proving the trans-cultural application of the guidelines.3.Five-class model best fit the data for eating disorder symptoms,which is well adapted to the new classification of eating disorders in the ICD-11.But a more precise classification of non-fat-phobic individuals and a more appropriate Body Mass Index cut-offs to determine thinness for Chinese are still in need.