Screening for eating disorders in a psychiatric outpatient population

Abstract

Background: Some studies have found ''hidden'' eating disorders in psychiatric patients. However, eating behaviour, weight, and body image concerns are usually weakly assessed among psychiatric patients. Objectives: a) To analyse the prevalence of eating disorders (ED) in patients referred from primary care for psychiatric assessment; and b) to analyse the psychopathological variables associated with these disorders. Methods. Ninety-three patients underwent psychometric assessment using Derogatis' Symptom Checklist-90-R, the Rosenberg Self-Esteem Scale, the Perceived Stress Questionnaire, the Eating Attitudes Test-40 (EAT-40), the Bulimic Investigatory Test, Edinburgh (BITE), and the Body Dissatisfaction Scale of the Eating Disorders Inventory-2. The subsequent clinical assessment, applying DSM-IV-R criteria for ED, was conducted by means of interview with those patients whose scores on the EAT-40 and BITE were above the cut-off points. Results: The assessments confirmed one case of bulimia nervosa and three of unspecified eating disorder, these accounting for 1.07% and 3.22%, respectively. Conclusion:The existence of hidden ED in psychiatric patients, especially as regards bulimic behaviour, and the correlation between eating disorder symptoms and different psychopathological variables make it important for clinicians to conduct a proper assessment when faced with ''anxiety and depressive syndromes'', which are a common feature of primary care referrals for psychiatric assessment.

Increased rates of eating disorders and their symptoms in women with major depressive disorder and anxiety disorders

“…Findings that mood and anxiety disorders are common in people with EDs have led clinicians to screen for these disorders in ED populations. Conversely, individuals with MDD/anxiety disorders are rarely screened for EDs or maladaptive eating habits (Jauregui Lobera et al, 2009). If disordered eating is substantially elevated across mood and anxiety disorders, then routine screening for EDs in these populations is also prudent.…”

Undetected eating disorders among adolescent psychiatric inpatients

“…The exact prevalence of UFED is unknown, however in a large cohort study of adolescent twins the prevalence of DSM‐5 UFED was found as 4.7% (Wade & O'Shea, 2015). In another study focusing on the psychiatric outpatient population referred from primary care, 3.2% met the criteria for UFED, using the DSM‐IV‐R criteria (Jauregui Lobera et al, 2009) The fact that UFED is among the frequently undetected diagnostic categories might be because of its symptoms being dismissed as insignificant. On the contrary, the evidence suggests that UFED cases are accompanied by significant clinical impairment and morbidity (Mustelin et al, 2016).…”

“…Primary care settings are among the most common sites patients with EDs first present and many of the patients reported to be undiagnosed (Lebow et al, 2021; Mond et al, 2007). Even fewer cases are recognized when patients present with complaints of other psychiatric disorders, especially anxiety syndromes (Becker et al, 2004; Lobera et al, 2009; Swinbourne & Touyz, 2007). Screening can be a successful method for identifying disordered eating, particularly in complex patients and in psychiatric treatment settings lacking formal assessments (Swinbourne & Touyz, 2007).…”