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Screening and Case Finding for Eating Disorders

Summary

It is widely acknowledged that eating disorders are prevalent and constitute significant health problems among young women. The aim of this chapter is to provide the rationale for general practitioners screening for patients suffering from eating disorders as well as suggest practical methods for case identification, early intervention and referral.  Screening and case finding are based on the assumption that early identification of a disorder can lead to earlier treatment thereby reducing morbidity and mortality. Screening for a variety of medical disorders has become routine in a range of different settings and involves testing presumably healthy volunteers from the general population for the purpose of separating them into groups that have either a high or a low probability of having a particular disorder. In contrast, case finding involves testing patients who have voluntarily sought health care or information as part of a comprehensive assessment of health. Health care workers may screen for certain disorders during routine physical examinations in patients who are at risk or in community-based voluntary settings.  Screening and case finding are not appropriate for every condition or disorder. Key indications for employing a screening for a disorder or condition are that it constitutes an important health problem, it is treatable, and that early identification leads to a favorable outcome. The decision to screen always depends on weighing factors including potential beneficial and harmful effects of testing for the individual as well as the population surveyed. In addition, the screening test employed should have desirable psychometric characteristics (including sensitivity, specificity and positive predictive value) as well as be relatively simple, economical, and acceptable to those asked to complete it. The efficiency of screening is depends on the validity or accuracy of the testing as well as on the prevalence of the disorder.  The main difference between screening and case finding is who initiates the initial contact. In both case finding and screening, the health professional must carefully evaluate the risks and the benefits of the procedures used as well as the practicability, effectiveness and the efficiency of the measures employed.  The EAT is a standardized, self-report measure of symptoms and concerns characteristic of eating disorders. It is designed to be economical both in administration and scoring time. The EAT has been used as a screening and case finding instrument in non-clinical populations. A factor analysis of the original 40-item EAT (Garner & Garfinkel, 1979) produced a 26-item abbreviated measure, the EAT-26 (Garner, Olmsted, Bohr, & Garfinkel, 1982). The total score of the EAT-26 is the sum of the scores of the individual scores on the test.

Original article for citation: Garner, D. M., Della Grave, R., & Piccini, F. (2000). Il ruolo del medico nello screening dei DCA [Screening and case finding for the general practitioner]. In F. Piccini (Ed.), Anoressia, bulimia, binge eating disorder (pp. 155-184). Torino, Italy: Centro Scientifico Editore. Click HERE to go to the full article.

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