Detection of bulimia in a primary care setting.
OBJECTIVE
To develop a screening tool for the identification of bulimia in ambulatory practice.


METHODS
Administration of a 112-item questionnaire about eating and weight-control practices to women with known bulimia and to healthy control patients. Questions were compared with DSM-III-R criteria of bulimia as a "gold standard."


METHODS
Self-help group for eating disorders and hospital-based primary care practice.


METHODS
Thirty of 42 women with known bulimia met DSM-III-R criteria for current bulimia, and 124 of 130 control patients met the criterion of no history of an eating disorder.


RESULTS
Thirteen individual questions discriminated between bulimic subjects and control subjects with a sensitivity and specificity of > 75%. When these questions were entered into a stepwise logistic model, two questions were independently significant. A "no" response to the question "Are you satisfied with your eating patterns?" or a "yes" response to "Do you ever eat in secret?" had a sensitivity of 1.00 and a specificity of 0.90 for bulimia. The positive predictive value, based on a 5% prevalence, was 0.36.


CONCLUSIONS
A set of two questions may be as effective as a more extensive questionnaire in identifying women with eating disorders, and could be easily incorporated into the routine medical history obtained from all women.
Women's Health Unit, University Hospital, Boston University Medical Center, Massachusetts 02118.
K M
KM
Freund
S M
SM
Graham
L G
LG
Lesky
M A
MA
Moskowitz
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000428:Alcohol Drinking; D002032:Bulimia / Q000175:diagnosis* / Q000523:psychology; D016009:Chi-Square Distribution; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D016015:Logistic Models; D015999:Multivariate Analysis; D010817:Physician-Patient Relations; D011237:Predictive Value of Tests; D011320:Primary Health Care / Q000379:methods*; D011581:Psychological Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires