Article

Feasibility and acceptability of screening for eating disorders in primary care

Department of Psychology, Institute of Psychiatry, King's College London, PO78, Addiction Sciences Building, London, UK.
Family Practice (Impact Factor: 1.84). 11/2007; 24(5):511-7. DOI: 10.1093/fampra/cmm029
Source: PubMed

ABSTRACT Earlier diagnosis of disordered eating is linked to improved prognosis, but detection in primary care is poor.
To assess the feasibility of screening for disordered eating within primary care, in terms of the proportion of patients accepting screening, yield of cases, action taken by staff and staff views on screening.
Data were collected in open GP surgeries, midwife (MW) antenatal clinics and health visitor (HV) child health surveillance clinics in two GP practices, using face-to-face surveys and semi-structured interviews. Female patients aged 16-35 were asked to complete the SCOFF questionnaire, which was scored by researchers and taken by the patient into their consultation. If the result indicated possible disturbed eating, the health professional (HP) running the surgery/clinic was asked to complete a questionnaire and interview. One hundred and eleven women were screened and 11 HPs (GPs, MWs, HVs) were interviewed.
Forty-six percent of patients agreed to be screened. Of these, 16% produced a positive result. The staff survey suggested that HPs found screening acceptable. However, concerns arose in the interviews, principally over what action to take in response to positive results. Positive results were rarely recorded in medical notes, and treatment was rarely offered.
In order for a screening programme for eating disorders to be implemented in primary care, HP concerns about options for dealing with positive results would need to be addressed. Feasibility of screening would be enhanced by production of a protocol to be followed in the case of positive results.

2 Followers
 · 
132 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Eating disorders adversely affect physical health, eating habits, social and family relationships, mood, work and school performance. We tested for cross-cultural validity of the Body Image Screening Questionnaire (BISQ), a screening measure validated in Spain, which assesses potential eating disorders related to anorexia, perception of obesity, orthorexia and vigorexia, in a Romanian sample from both clinical and general populations. The measure showed adequate internal consistency and allowed distinguishing clinical vs. general subsamples. Significant differences based on clinical characteristics were obtained. The measure can be utilized as screening tool of individuals who need further assessment and prioritize primary intervention strategies with at risk population.
    Procedia - Social and Behavioral Sciences 01/2012; 33:423–427. DOI:10.1016/j.sbspro.2012.01.156
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Psychosocial screening has been recommended for pediatric patients with newly diagnosed type 1 diabetes and their families. Our objective was to assess a psychosocial screening protocol in its feasibility, acceptability to families, and ability to predict early emerging complications, nonadherent family behavior, and use of preventive psychology services. A total of 125 patients and their caregivers were asked to participate in a standardized screening interview after admission at a large urban children's hospital with a new diagnosis of type 1 diabetes. Medical records were reviewed for subsequent diabetes-related emergency department (ED) admissions, missed diabetes clinic appointments, and psychology follow-up within 9 months of diagnosis. Of 125 families, 121 (96.8%) agreed to participate in the screening, and a subsample of 30 surveyed caregivers indicated high levels of satisfaction. Risk factors at diagnosis predicted subsequent ED admissions with a sensitivity of 100% and a specificity of 98.6%. Children from single-parent households with a history of behavior problems were nearly six times more likely to be seen in the ED after diagnosis. Missed appointments were likeliest among African Americans, 65% of whom missed at least one diabetes-related appointment. Psychology services for preventive intervention were underutilized, despite the high acceptability of the psychosocial screening. Psychosocial screening of newly diagnosed patients with type 1 diabetes is feasible, acceptable to families, and able to identify families at risk for early emerging complications and nonadherence. Challenges remain with regards to reimbursement and fostering follow-up for preventive care.
    Diabetes care 02/2011; 34(2):326-31. DOI:10.2337/dc10-1553 · 8.57 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Accurate diagnosis of eating disorders may facilitate appropriate management of the conditions. Currently, little information is available regarding the accuracy of eating disorder diagnoses made in routine primary care. To evaluate the accuracy of eating disorder diagnoses made in primary care settings, and to compare the accuracy of primary care diagnoses with those generated using patient self-report questionnaires. Participants were 212 consecutive referrals to an outpatient eating disorder programme, who were found to have a DSM-IV eating disorder upon assessment with the Eating Disorder Examination (EDE). Primary care diagnoses were taken from referral letters and forms. Self-report diagnoses were generated using self-report responses to the Eating Disorder Examination-Questionnaire (EDE-Q). Primary care practitioners were accurate in identifying anorexia and bulimia nervosa, but inaccurate in identifying atypical presentations (e.g. eating disorders not otherwise specified [EDNOS]). Convergence between the EDE and the EDE-Q was modest, and the EDE-Q tended to overestimate the incidence of EDNOS. 'Atypical' eating disorder presentations tend to be misdiagnosed in primary care settings, although practitioners are generally accurate in distinguishing between anorexia-like and bulimia-like presentations. This has implications for the management of eating disorders in primary care settings.
    Journal of Mental Health 06/2011; 20(3):270-80. DOI:10.3109/09638237.2011.562259 · 1.01 Impact Factor

Preview

Download
2 Downloads