title: The demand for eating disorder care. An epidemiological study using the general practice research database.
abstract: BACKGROUND
  An epidemiological study of anorexia nervosa and bulimia nervosa in primary care was performed using the General Practice Research Database (GPRD).
  
  
  METHODS
  The GPRD was screened between 1988 and 1994 for newly diagnosed cases of anorexia nervosa and bulimia nervosa. The validity of the computer diagnosis was established by obtaining clinical details from a random sample of the general practitioners (GPs).
  
  
  RESULTS
  Incidence rates for detection of cases by GPs in 1993 was 4.2 per 100,000 population for anorexia nervosa, and 12.2 per 100,000 for bulimia nervosa. The relative risks of females to males was 40:1 for anorexia nervosa and 47:1 for bulimia nervosa. A threefold increase in the recording of bulimia nervosa was found from 1988 to 1993. Eighty per cent of anorexia nervosa cases and 60% of bulimia nervosa cases were referred to secondary care.
  
  
  CONCLUSIONS
  There is a continuing expansion of service need for bulimia nervosa. The majority of cases of eating disorders are referred to secondary services. There is scope for more effective management of bulimia nervosa in primary care.
authors.affiliation: Eating Disorders Unit, Institute of Psychiatry, London.
authors.forename: S
authors.initials: S
authors.lastname: Turnbull
authors.forename: A
authors.initials: A
authors.lastname: Ward
authors.forename: J
authors.initials: J
authors.lastname: Treasure
authors.forename: H
authors.initials: H
authors.lastname: Jick
authors.forename: L
authors.initials: L
authors.lastname: Derby
mesh_terms: D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D002032:Bulimia / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D002648:Child; D003430:Cross-Sectional Studies; D004739:England / Q000453:epidemiology; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007256:Information Systems; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012744:Sex Ratio; D014852:Wales / Q000453:epidemiology