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J Ment Health. 2011 Jun;20(3):270-80. doi: 10.3109/09638237.2011.562259.

Eating disorder diagnoses in general practice settings: comparison with structured clinical interview and self-report questionnaires.

Author information

  • 1Centre for Clinical Interventions, Northbridge, Western Australia, Australia. karina.allen@uwa.edu.au

Abstract

BACKGROUND:

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.

AIMS:

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.

METHOD:

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).

RESULTS:

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.

CONCLUSION:

'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.

PMID:
21574792
[PubMed - indexed for MEDLINE]
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