Screening for binge eating disorders using the Patient Health Questionnaire in a community sample

Abstract

Objective-To examine the operating characteristics of the Patient Health Questionnaire eating disorder module (PHQ-ED) for identifying bulimia nervosa/binge eating disorder (BN/BED) or recurrent binge eating (RBE) in a community sample, and to compare true positive (TP) versus false positive (FP) cases on clinical validators.Method-259 screen positive individuals and a random sample of 89 screen negative cases completed a diagnostic interview. Sensitivity, specificity, and Positive Predictive Value (PPV) were calculated. TP and FP cases were compared using t-tests and Chi-Square tests.Results-The PHQ-ED had high sensitivity (100%) and specificity (92%) for detecting BN/BED or RBE, but PPV was low (15% or 19%). TP and FP cases did not differ significantly on frequency of subjective bulimic episodes, objective overeating, restraint, on BMI, and on selfrated health.Conclusions-The PHQ-ED is recommended for use in large populations only in conjunction with follow-up questions to rule out cases without objective bulimic episodes.

Cognitive behavioral guided self-help for the treatment of recurrent binge eating.

“…Participants who reported binge eating at least once per week during the past three months (“screen-positive”) were invited to participate in further assessment to verify study eligibility. As previously reported, the PHQ-ED had high sensitivity and specificity (Striegel-Moore, Perrin, et al, in press). As evident from Figure 1, however, a large number of screened participants were found to be “false positive” cases, supporting the need to conduct the confirmatory diagnostic interviews described below.…”

“…All participants underwent a two-stage case finding procedure involving initial screening followed by a confirmatory diagnostic interview by study staff unaware of the screening status (Striegel-Moore, Perrin, et al, in press). Excluded from sampling were individuals with diagnostic codes indicative of severe cognitive impairment or psychosis, individuals currently being treated for cancer, women who were pregnant or had given birth in the past four months, and approximately 100 plan members whose records indicated an a priori opt-out from any study participation.…”

Cost-effectiveness of guided self-help treatment for recurrent binge eating.

“…In brief, recruitment initially involved mailings to a random sample of male and female health plan members for an epidemiological study on eating habits and body image (Striegel-Moore, Rosselli, et al, in press). All participants underwent a two-stage case finding procedure involving initial screening followed by a confirmatory diagnostic interview by study staff unaware of the screening status (Striegel-Moore, Perrin, et al, in press). Briefly, 1,092 persons were eligible per the initial screener, 541 of those refused participation [either did not respond (344) or refused further participation in the study (197)], 551 were interviewed with the comprehensive assessment to confirm presence of recurrent binge eating and eating disorder diagnoses based on the 4 th edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2000).…”

The Eating Disorder Inventory in the screening for DSM-5 binge eating disorder

“…The PHQ-ED yielded a high sensitivity (100%) and specificity (92%) (Striegel-Moore et al, 2010) in a randomly selected community sample. The PHQ-ED is also shorter than the EDI, which is an advantage, as brevity increases the utility of a screening instrument both in community settings and the clinic.…”

“…Several alternative instruments have been developed to screen for BED, and many of them have reasonable screening properties (Borges et al, 2005;Celio et al, 2004;Grupski et al, 2013;Striegel-Moore et al, 2010;Vander Wal et al, 2011). However, we believe that the EDI has some important advantages.…”