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Detecting eating disorder patients in a general practice setting: a systematic review of heterogeneous data on clinical outcomes and care trajectories

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Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity Aims and scope Submit manuscript

Purpose

Abstract

The incidence and prevalence of eating disorders (ED) is low in general practice (GP) settings. Studies in secondary care suggest that the general practitioner has an important role to play in the early detection of patients with EDs. The aim of this study was to describe the effect (clinical outcomes and care trajectory) of screening for EDs among patients in general practice settings.

Methods

A systematic review was conducted on Medline, PsycINFO, CINAHL, Embase and WOS. The studies included were to have been carried out in a primary care setting, with screening explicitly performed in GP practices and follow-up information.

Results

Ten studies met the inclusion criteria. For all ED patients, there was an increase in the frequency of consultations in GP setting, referrals to psychiatric resources and drug prescriptions such as antidepressants, following screening procedures. Clinical outcomes remained unclear and heterogeneous. One study focused on the course and outcome of ED patients identified by screening in the GP setting and reported recovery for anorexia nervosa (AN) and BN in more than half of the cases, after 4.8 years of mean follow-up. In this study, early age at detection predicted better recovery.

Conclusion

Most of the literature on the role of the GP in screening for and managing EDs consists of opinion papers and original studies designed in a secondary care perspective. The impact of systematically screening for EDs in a primary care setting is not clarified and requires further investigation in collaborative cohort studies with a patient-centered approach, and outcomes focused on symptoms.

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Acknowledgments

We acknowledge Aurelie Deniau, GP in Tours, who helped to collect data.

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Authors and Affiliations

  1. Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM U1178, Villejuif, France

    Jean Sébastien Cadwallader, Nathalie Godart, Bruno Falissard & Caroline Huas

  2. Department of General Practice, Faculty of Medicine Pierre and Marie Curie, Sorbonne Universités, UPMC Univ Paris 06, Paris, France

    Jean Sébastien Cadwallader & Julie Chastang

  3. Department of Psychiatry, Institut Mutualiste Montsouris, Paris, France

    Nathalie Godart

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  1. Jean Sébastien Cadwallader
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Correspondence to Jean Sébastien Cadwallader.

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Cadwallader, J.S., Godart, N., Chastang, J. et al. Detecting eating disorder patients in a general practice setting: a systematic review of heterogeneous data on clinical outcomes and care trajectories. Eat Weight Disord 21, 365–381 (2016). https://doi.org/10.1007/s40519-016-0273-9

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