Variables that influence diagnosis and treatment of the eating disorders within primary care settings: A vignette study

Authors

  • Laura Currin BA, PhD,

    Corresponding author
    1. King's College London, Institute of Psychiatry, Eating Disorders Section, London, England
    • King's College London, Institute of Psychiatry, Section of Eating Disorders Box 059, De Crespigny Park, London SE5 8AF, England
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  • Ulrike Schmidt MD, PhD,

    1. King's College London, Institute of Psychiatry, Eating Disorders Section, London, England
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  • Glenn Waller BA, MClinPsychol, DPhil

    1. King's College London, Institute of Psychiatry, Eating Disorders Section, London, England
    2. Vincent Square Eating Disorders Service, Central and North-West London Mental Health NHS Trust, London, England
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Abstract

Objective:

This study examined the influence of clinical and nonclinical features of case presentation on the diagnosis and treatment of eating disorders in primary care.

Method:

Family physicians from a defined region of the UK were provided with two vignettes, characterizing eating disorder presentations in primary care. Case gender, ethnicity, weight status, and diabetes history were experimentally manipulated. Outcome variables included the primary diagnosis and the treatment course selected for each case.

Results:

Female cases were more likely to receive an eating disorder diagnosis, even when their symptoms were identical to those of males. Nonclinical demographic variables also influenced treatment decisions. Weight status and physical comorbidity had a limited influence on treatment pathways.

Conclusion:

Nonclinical features of case presentations are used when making eating disorder diagnoses and in selecting treatment. Decision-making in primary care does not reflect recommendations from clinical guidance, and this disparity might increase the risk of complications in the care of sub-groups of eating-disordered patients. © 2006 by Wiley Periodicals, Inc. Int J Eat Disord 2007

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