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

Allen, Karina L.; Fursland, Anthea; Watson, Hunna J.; Byrne, Susan

doi:10.3109/09638237.2011.562259

Cited by 17 publications

(16 citation statements)

References 31 publications

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“…Moreover, not all patients with BN or BED reported the behavior through self-report. The fact that self-reports and interview data might differ in various directions has been noted earlier [49-52] and especially the tendency to under-diagnose BN using self-report questionnaires [50]. Moreover, the SEDI has only been validated against the EDE interview [27], and no study has so far investigated the concordance between SEDI and EDE-Q.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics and distinctiveness of DSM-5 eating disorder diagnoses: findings from a large naturalistic clinical database

et al. 2013

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BackgroundDSM-IV eating disorder (ED) diagnoses have been criticized for lack of clinical utility, diagnostic instability, and over-inclusiveness of the residual category “ED not otherwise specified” (EDNOS). Revisions made in DSM-5 attempt to generate a more scientifically valid and clinically relevant system of ED classification. The aim with the present study was to examine clinical characteristics and distinctiveness of the new DSM-5 ED diagnoses, especially concerning purging disorder (PD). MethodsUsing a large naturalistic Swedish ED database, 2233 adult women were diagnosed using DSM-5. Initial and 1-year follow-up psychopathology data were analyzed. Measures included the Eating Disorder Examination Questionnaire, Structural Eating Disorder Interview, Clinical Impairment Assessment, Structural Analysis of Social Behavior, Comprehensive Psychiatric Rating Scale, and Structured Clinical Interview for DSM-IV Axis I Disorders.ResultsFew meaningful differences emerged between anorexia nervosa binge/purge subtype (ANB/P), PD, and bulimia nervosa (BN). Unspecified Feeding and Eating Disorders (UFED) showed significantly less severity compared to other groups.ConclusionsPD does not appear to constitute a distinct diagnosis, the distinction between atypical AN and PD requires clarification, and minimum inclusion criteria for UFED are needed. Further sub-classification is unlikely to improve clinical utility. Instead, better delineation of commonalities is important.

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Section: Discussionmentioning

confidence: 99%

Clinical characteristics and distinctiveness of DSM-5 eating disorder diagnoses: findings from a large naturalistic clinical database

et al. 2013

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“…In a study by Turnbull, Ward, Treasure, Jick, and Derby (1996), using data from the general practice research database (GPRD) the positive predictive value for a diagnosis of AN or BN was above 90%, which is extremely good. Amongst cases referred to an outpatient ED service in Australia, GPs – who were the majority of referrers (82%) 65% of cases were correctly diagnosed by GPs (as compared to the eating disorders examination [EDE]), with the main difference being an under-recognition of Eating Disorder Not Otherwise Specified (EDNOS) by GPs, but overall GPs were able to identify AN-like and BN-like disorders (Allen, Fursland, Watson, & Byrne, 2011). Given that as specialists we also struggle with the notion of what is EDNOS, I believe that is pretty good going.…”

Section: Gps Are Not Poor At Identifying the Eds: Nadiamentioning

confidence: 99%

General Practitioners are poor at identifying the eating disorders

Waller

Micali

James

2014

Advances in Eating Disorders

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“…The presence of an ED also increases the rate of presentations to Emergency Departments [4]. In terms of accuracy of diagnosis, AN is the ED most often accurately diagnosed by primary care physicians [8]. Atypical cases, or those who do not present with all diagnostic criteria, can be misdiagnosed [9] or considered ‘less serious’ despite clearly having a clinically significant disorder that squarely sits within the AN spectrum.…”

Section: Introductionmentioning

confidence: 99%

Assessment of anorexia nervosa: an overview of universal issues and contextual challenges

Surgenor

Maguire

2013

J Eat Disord

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AimAnorexia Nervosa (AN) is a complex and clinically challenging syndrome. Intended for specialist audiences, this narrative review aims to summarise the available literature related to assessment in the adult patient context, synthesising both research evidence and clinical consensus guidelines.MethodWe provide a review of the available literature on specialist assessment of AN focusing on common trajectories into assessment, obstacles accessing assessment, common presenting issues and barriers to the assessment process, the necessary scope of assessment, and tools and techniques. It describes the further step of synthesising assessment information in ways that can inform resultant care plans.ResultsIn addition to assessment of core behaviours and diagnostic skills, considerations for the expert assessor include the functions of primary care, systemic and personal barriers, knowledge of current assessment tools and research pertaining to comorbid pathology in AN, assessing severity of illness, role of family at assessment, as well as medical, nutritional and compulsory elements of assessment.ConclusionComprehensive assessment of AN in the current healthcare context still remains largely the remit of the specialist ED clinician. Assessment should remain an on-going process, paying particular attention to available empirical evidence, thereby reducing the gap between research and practice.

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

Cited by 17 publications

References 31 publications

Clinical characteristics and distinctiveness of DSM-5 eating disorder diagnoses: findings from a large naturalistic clinical database

Clinical characteristics and distinctiveness of DSM-5 eating disorder diagnoses: findings from a large naturalistic clinical database

General Practitioners are poor at identifying the eating disorders

Assessment of anorexia nervosa: an overview of universal issues and contextual challenges

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