Health service utilization for eating disorders: Findings from a community-based study
ABSTRACT Prior use of health services was examined in a community sample of women with bulimic-type eating disorders.
Participants (n = 159) completed a structured interview for the assessment of eating disorder psychopathology as well as questions concerning treatment-seeking and type of treatment received.
Whereas a minority (40.3%) of participants had received treatment for an eating problem, most had received treatment for a general mental health problem (74.2%) and/or weight loss (72.8%), and all had used one or more self-help treatments. Where treatment was received for an eating or general mental health problem, this was from a primary care practitioner in the vast majority of cases. Only half of those participants who reported marked impairment associated with an eating problem had ever received treatment for such a problem and less than one in five had received such treatment from a mental health professional.
Women with bulimic-type eating disorders rarely receive treatment for an eating problem, but frequently receive treatment for a general mental health problem and/or for weight loss. The findings underscore the importance of programs designed to improve the detection and management of eating disorders in primary care.
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ABSTRACT: Studies of quality of life among individuals with eating disorders have relied almost exclusively on clinical samples. We examined impairment in quality of life in a community sample of women with eating disorders recruited as part of an epidemiological study. Measures of health-related quality of life (Medical Outcomes Study 12-item Short-Form Physical and Mental Component Summary scales) and subjective well-being (WHOQOL-BREF Psychological Functioning and Social Relationships subscales) were completed by women with eating disorders (n = 159), primarily variants of bulimia nervosa and binge eating disorder, and a comparison group of healthy women (n = 232). When compared with healthy women, women with eating disorders reported substantial impairment in aspects of quality of life relating to mental health, although item-level analysis indicated considerable variation in the extent to which specific aspects of emotional well-being were affected. Impairment in social relationship and in physical health was less pronounced and due, at least in part, to between-group differences in age, body weight and demographic characteristics. Impairment in certain aspects of perceived physical health was, however, apparent among women with eating disorders, even after controlling for between-group differences in body weight. Community cases of women with eating disorders experience marked impairment in quality of life as this relates to mental health functioning and at least some impairment in physical health functioning. Personality characteristics and ego-syntonic aspects of eating-disordered behaviour may complicate the interpretation of findings relating to impairment in specific aspects of quality of life.Australian and New Zealand Journal of Psychiatry 06/2012; 46(6):561-8. DOI:10.1177/0004867411433967 · 3.77 Impact Factor
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ABSTRACT: Few with eating disorders (EDs) access evidence-based treatments. We conducted a prospective exploration of help-seeking by 57 community women with bulimic-type EDs using the Framework approach of familiarization, identifying themes, indexing, charting and mapping and interpretation. The mean age of the sample was 33 years. Results found women sought help for concerns regarding perceived (over) weight rather than for eating, although many women would have welcomed questions from professionals regarding eating behaviours. Empathy, providing information and hope were considered important features of health professionals to provide a positive experience of help-seeking. Specific personal barriers to treatment included low motivation, fear of stigma, and cost. Greater clinician and community awareness of and action on these issues would likely help close "the gap" for effective help-seeking by those with EDs.Eating disorders 05/2011; 19(3):270-85. DOI:10.1080/10640266.2011.566152
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ABSTRACT: We sought to further explore the validity of the distinction between objective bulimic episodes (OBEs) and subjective bulimic episodes (SBEs) in the study of bulimic-type eating disorders. Drawing on data obtained at the second, interview phase of a large-scale epidemiological study, we identified mutually exclusive subgroups of women with bulimic-type eating disorders who engaged in regular OBEs but not SBEs (n = 37) or regular SBEs but not OBEs (n = 52). These subgroups were compared on a wide range of outcomes, including socio-demographic characteristics, current levels of eating disorder psychopathology, general psychological distress and impairment in role functioning, current and lifetime impairment in quality of life specifically associated with an eating problem, (self)-recognition of an eating problem, health service utilization and use of psychotropic medication. The only difference between groups was that participants who reported regular OBEs were heavier than those who reported regular SBEs. The findings converge with those of previous research in suggesting that bulimic-type eating disorders characterized by regular SBEs, but not OBEs, do not differ in any clinically meaningful way from those characterized by regular OBEs, but not SBEs. Inclusion of bulimic-type eating disorders characterized by regular SBEs as a provisional category requiring further research in DSM-V appears warranted.Behaviour Research and Therapy 07/2010; 48(7):661-9. DOI:10.1016/j.brat.2010.03.020 · 3.85 Impact Factor