Journal of General Internal Medicine

, Volume 18, Issue 1, pp 53–56

Four simple questions can help screen for eating disorders

  • Mary-Anne Cotton
  • Christopher Ball
  • Paul Robinson
Brief Report

Abstract

Current screening instruments for eating disorders are cumbersome to administer and have not been validated in primary care populations. We compared the performance characteristics of 2 screening tools, the SCOFF clinical prediction guide, and a new set of questions, the Eating disorder Screen for Primary care (ESP), using the Questionnaire for Eating Disorders Diagnosis as the independent standard, in 104 consecutive patients from a primary care practice and 129 university students. Twelve percent of the combined population had an eating disorder. One or no abnormal responses to the ESP ruled out an eating disorder (likelihood ratio [LR] 0.0), whereas 3 or more abnormal responses ruled one in (LR 11). The SCOFF questions were less sensitive than predicted (1 or no abnormal responses, LR 0.25), but were as effective at ruling in an eating disorder (3 or more abnormal responses, LR 11).

Key words

eating disorders diagnosis screening 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Whitehouse AM, Cooper PJ, Vize CV, Hill C, Vogel L. Prevalence of eating disorders in three Cambridge general practices: hidden and conspicuous morbidity. Br J Gen Pract. 1992;42:57–60.PubMedGoogle Scholar
  2. 2.
    King MB. Eating disorders in a general practice population. Prevalence, characteristics and follow-up at 12 to 18 months. Psychol Med Monogr Suppl. 1989;14:1–34.PubMedGoogle Scholar
  3. 3.
    Ghadirian AM, Englesmann F, Leichner P. Prevalence of psychosomatic and other medical illnesses in anorexic and bulimic patients. Behav Neurol. 1993;6:123–7.Google Scholar
  4. 4.
    Herzog DB, Keller MB, Sacks NR, Yeh CJ, Lavori PW. Psychiatric comorbidity in treatment-seeking anorexics and bulimics. J Am Acad Child Adolesc Psychiatry. 1992;31:810–8.PubMedCrossRefGoogle Scholar
  5. 5.
    Fahy TA, Russell GF. Outcome and prognostic variables in bulimia nervosa. Int J Eat Disord. 1993;14:135–45.PubMedCrossRefGoogle Scholar
  6. 6.
    Garner DM. The Eating Attitudes Test: an index of the symptoms of anorexia nervosa. Psycholog-Med. 1979;9:273–9.CrossRefGoogle Scholar
  7. 7.
    Garner DM, Olmstead MP, Polivy J. Development and validation of a multidimensional eating disorder inventory for anorexia nervosa and bulimia. Int J Eat Disord. 1983;2:15–34.CrossRefGoogle Scholar
  8. 8.
    Fichter MM, Herpertz S, Quadflieg N, Herpertz-Dahlmann B. Structured interview for anorexic and bulimic disorders for DSM-IV and ICD-10: updated (third) revision. Int J Eat Disord. 1998;24:227–49.PubMedCrossRefGoogle Scholar
  9. 9.
    Anstine D, Grinenko MD. Rapid screening for disordered eating in college-aged females in the primary care setting. J Adolesc Health. 2000;26:338–42.PubMedCrossRefGoogle Scholar
  10. 10.
    Freund KM, Graham SM, Lesky LG, Moskowitz MA. Detection of bulimia in a primary care setting. J Gen Intern Med. 1993;8:236–42.PubMedCrossRefGoogle Scholar
  11. 11.
    McNulty PAF. Prevalence and contributing factors of eating disorder behaviours in active duty navy men. Mil Med. 1997;162:753–9.PubMedGoogle Scholar
  12. 12.
    Morgan JF, Reid F, Lacey H. The SCOFF questionnaire: assessment of a new screening tool for eating disorders. BMJ. 1999;319:1467–8.PubMedGoogle Scholar
  13. 13.
    Welch G, Hall A. Is the prevalence of bulimia nervosa higher among tertiary education population? N Z Med J. 1990;103:476–7.PubMedGoogle Scholar
  14. 14.
    Mintz LB, O’Halloran MS, Mulholland AM. Questionnaire for eating disorder diagnoses: reliability and validity of operationalizing DSM-IV criteria into a self-report format. J Couns Psychol. 1997;44:63–79.CrossRefGoogle Scholar
  15. 15.
    Gotestam KG, Agras WS. General population-based epidemiological study of eating disorders in Norway. Int J Eat Disord. 1995;18:119–26.PubMedCrossRefGoogle Scholar
  16. 16.
    Abraham S. Characteristics of eating disorders among young ballet dancers. Psychopathology. 1996;29:223–9.PubMedCrossRefGoogle Scholar
  17. 17.
    Le Grange D, Tibbs J, Noakes TD. Implications of a diagnosis of anorexia nervosa in a ballet school. Int J Eat Disord. 1994;15:369–76.PubMedCrossRefGoogle Scholar
  18. 18.
    Santonastaso P, Zanetti T, Sala A, Favaretto G, Vidotto G, Favaro A. Prevalence of eating disorders in Italy: a survey on a sample of 16 year old female students. Psychother Psychosom. 1996;65(3):158–62.PubMedGoogle Scholar

Copyright information

© Society of General Internal Medicine 2003

Authors and Affiliations

  • Mary-Anne Cotton
    • 1
  • Christopher Ball
    • 2
  • Paul Robinson
    • 3
  1. 1.University College LondonLondon
  2. 2.the Centre for Evidence-based MedicineOxford
  3. 3.the Royal Free HospitalLondon

Personalised recommendations