General practice consultation patterns preceding diagnosis of eating disorders

Abstract

Objective To see whether patients with eating disorders consult general practitioners more frequently than control subjects and, if so, to describe the pattern of consultation. Method: General practitioner case record review of patients with anorexia nervosa, bulimia nervosa, and partial syndromes referred to a specialist eating disorder service. Results: Seventy‐eight of 100 case records were available for analysis. Eating disorder patients consulted significantly more frequently than controls over 5 years prior to the diagnosis of the eating disorder. They presented to the general practitioners with a variety of symptoms including psychological, gastrointestinal, and gynecological complaints. Discussion: The findings suggest that methods could be developed to enable earlier diagnosis of eating disorders in general practice. This will enable the earlier application of effective treatments with the prospect of improved outcome. © 1997 by John Wiley & Sons, Inc. Int J Eat Disord 22: 89–93, 1997.

Sex difference in using the SCOFF questionnaire to identify eating disorder patients at a psychiatric outpatient clinic

“…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].…”

Eating disorders and irritable bowel syndrome: is there a link?

“…In AN, constipation and abdominal pain are common [4]. Moreover, prior to presenting with an ED, many patients attend their general practitioner complaining of gastrointestinal symptoms [5]. Conversely, once an ED is well established, a broad range of gastrointestinal symptoms results, either directly from poor dietary habits and self-starvation or secondary to electrolyte disturbances or laxative misuse [6].…”

Treatment of anorexia nervosa: a multimethod investigation translating experimental neuroscience into clinical practice

“…75 Little is known about the service use of people with AN prior to entering treatment, but there is some evidence on elevated service use up to 5 years prior to diagnosis. 21,22 For our higher cost estimate, we draw on baseline information from the three trials analysed in Chapter 11 to estimate a plausible range of primary care costs (GP, nurse, dietitian) incurred prior to an inpatient admission or outpatient treatment. When treatment is provided exclusively in primary care, we assume that each person is in contact with their GP three times per year (NICE 2004 ED guidance 162 ).…”

“…19,20 People with AN consult their general practitioner (GP) significantly more than others in the 5 years prior to diagnosis. 21 A single consultation about eating or weight/shape concerns strongly predicts the subsequent emergence of AN. 22 Although GPs exclusively treat 20% of cases with AN, 23 they are often not confident at managing AN, 24 and there is usually a considerable delay between a diagnosis being made in primary care and the point when more specialist help becomes available.…”