Health service utilization for eating disorders: Findings from a community-based study

School of Psychological Science, La Trobe University, Bundoore VIC 3083, Australia.
International Journal of Eating Disorders (Impact Factor: 3.13). 07/2007; 40(5):399-408. DOI: 10.1002/eat.20382
Source: PubMed


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.

1 Read
    • "Previous studies have highlighted the need for early diagnosis and intervention to improve the prognosis of EDs[5]. Notably, those with a diagnosis of ED are usually more aware of cooccurring general mental health problems or medical conditions than eating problems per se[6,7]. Most patients with EDs remain unrecognized in the primary care settings or general mental health settings[8]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Patients with eating disorder (ED) often remain unrecognized in many settings. Few studies have explored the use of eating measures in an adult male population. This study aimed to examine the comparative validity of the SCOFF questionnaire for detecting ED cases in men and women in the psychiatric outpatient setting.Method Psychiatric outpatients, including 605 men and 936 women, aged 18–45 years, completed the paper form SCOFF and were interviewed using the ED Module of the Structured Clinical Interview for the DSM-IV-TR. A subgroup of patients completed several additional self-reported questionnaires concerning eating and general psychopathology.ResultsScores of 2 and 3 on the SCOFF were the optimal cutoff values for determining ED among men (sensitivity 86% and specificity 74%) and women (sensitivity 80% and specificity 86%), respectively. While age did not significantly affect the validity indices, the SCOFF as a screening tool for ED in obese men was underperformed.Conclusions The Mandarin Chinese version of the SCOFF is a potentially valid tool to detect ED in both genders in the psychiatric outpatient settings. By helping to detect hidden ED morbidity, the SCOFF can enhance diagnostic accuracy and facilitate comprehensive treatment among psychiatric outpatients.
    No preview · Article · Feb 2015 · Comprehensive Psychiatry
  • Source
    • "A limitation of the current study is the use of a treatment-seeking sample. Many individuals with EDs do not seek treatment from specialist services [44-47] and so findings in this sample may not generalise to other groups, such as community samples of people with EDs. Bohn and colleagues [26] note that it is often psychosocial impairment that leads people with EDs to seek help and so we might expect that a treatment-seeking sample will be particularly impaired. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background This study aimed to assess differences in Quality of Life (QoL) across eating disorder (ED) diagnoses, and to examine the relationship of QoL to specific clinical features. Results 199 patients with a diagnosed ED completed the Clinical Impairment Assessment (CIA) [Cognitive Behavior Therapy and Eating Disorders, 315–318, 2008] and the Eating Disorders Examination (EDE) [Int J Eat Disord 6:1–8]. Differences between diagnostic groups were examined, as were differences between restrictive and binge-purge subtypes. CIA scores and EDE scores were positively correlated and higher in groups with binge-purge behaviours. CIA scores were not correlated with BMI, illness duration or frequency of bingeing/purging behaviours, except in the binge-purge AN group, where CIA scores negatively correlated with BMI. Conclusions Patients with EDs have poor QoL and impairment increases with illness severity. Patients with binge/purge diagnoses are particularly impaired. It remains unclear which clinical features best predict the degree of impairment experienced by patients with EDs.
    Full-text · Article · Nov 2013 · International Journal of Eating Disorders
  • Source
    • "Inclusion of BED as a formal diagnosis is significant, though, because it will have the effect of reducing the proportion of individuals with eating disorders who would otherwise have fallen into the DSM-5 “Feeding or Eating Disorder Not Elsewhere Classified” category [15,28]. Currently, as many as half of individuals with eating disorders receive the DSM-IV diagnosis of EDNOS and this is the case in both community and clinical samples [30,31]. Not surprisingly, concerns have been expressed about a classification scheme that relegates such a high proportion of cases to a residual category [31,32]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Proposed changes to the classification of bulimic-type eating disorders in the lead up to the publication of DSM-5 are reviewed. Several of the proposed changes, including according formal diagnostic status to binge eating disorder (BED), removing the separation of bulimia nervosa (BN) into purging and non-purging subtypes, and reducing the binge frequency threshold from twice per week to once per week for both BN and (BED), have considerable empirical evidence to support them and will likely have the effect of facilitating clinical practice, improving access to care, improving public and professional awareness and understanding of these disorders and stimulating the additional research needed to address at least some problematic issues. However, the omission of any reference to variants of BN characterized by subjective, but not objective, binge eating episodes, and to the undue influence of weight or shape on self-evaluation or similar cognitive criterion in relation to the diagnosis of BED, is regrettable, given their potential to inform clinical and research practice and given that there is considerable evidence to support specific reference to these distinctions. Other aspects of the proposed criteria, such as retention of behavioral indicators of impaired control associated with binge eating and the presence of marked distress regarding binge eating among the diagnostic for BED, appear anomalous in that there is little or no evidence to support their validity or clinical utility. It is hoped that these issues will be addressed in final phase of the DSM-5 development process.
    Full-text · Article · Aug 2013 · International Journal of Eating Disorders
Show more