Eating disorders: A hidden phenomenon in outpatient mental health?


  • Anthea Fursland PhD,

    1. Department of Health in Western Australia, Centre for Clinical Interventions, Perth, Australia
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  • Hunna J. Watson PhD

    Corresponding author
    1. Department of Health in Western Australia, Centre for Clinical Interventions, Perth, Australia
    2. Eating Disorders Program, Princess Margaret Hospital for Children, Perth, Australia
    3. School of Paediatrics and Child Health, The University of Western Australia, Perth, Australia
    4. School of Psychology and Speech Pathology, Curtin University, Perth, Australia
    • Correspondence to: Dr. Hunna Watson, Centre for Clinical Interventions, 223 James Street, Northbridge, Western Australia, Australia. E-mail:

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Eating disorders are common but underdiagnosed illnesses. Help-seeking for co-occurring issues, such as anxiety and depression, are common.


To identify the prevalence of eating problems, using the SCOFF, and eating disorders when screening positive on the SCOFF (i.e., ≥2), among patients seeking help for anxiety and depression at a community-based mental health service.


Patients (N = 260) consecutively referred and assessed for anxiety and depression treatment were administered the SCOFF screening questionnaire and a semi-structured standardized diagnostic interview during routine intake.


18.5% (48/260) scored ≥2 on the SCOFF, indicating eating problems. Of these, 41% (19/48) met criteria for an eating disorder. Thus, overall, 7.3% (19/260) of the sample met criteria for a DSM-IV eating disorder. Those scoring ≥2 on the SCOFF were more likely to: be female (p = 0.001), younger (p = 0.003), and have a history of self-harm (p < 0.001).


This study confirms that eating disorders are a hidden phenomenon in general outpatient mental health. By using a standardized diagnostic interview to establish diagnosis rather than self- or staff-report, the study builds on limited previous findings. The naturalistic study setting shows that screening for eating disorders can be easily built into routine intake practice, and successfully identifies treatment need. © 2013 Wiley Periodicals, Inc. (Int J Eat Disord 2014; 47:422–425)