title: Diabetes and eating disorders in primary care.
abstract: OBJECTIVE
  To determine the relationship between diabetes and eating disorders among primary care patients.
  
  
  METHODS
  Data on 3,000 patients were obtained from eight primary care and family practice settings, including the PRIME-MD Patient Health Questionnaire (PHQ), self-reported physical illness, and social functioning information. Multivariate logistic regression analyses were used to determine the association between diabetes and eating disorders.
  
  
  RESULTS
  Diabetes was associated with an increased likelihood of eating disorders [OR = 2.3 (1.4, 3.9)], after adjusting for differences in demographic characteristics and comorbid mental disorders. This effect was specific to diabetes. Eating disorder was the only mental disorder associated with a significantly increased risk of diabetes, odds ratio (OR) = 2.4 (1.4, 4.0), after adjusting for demographic characteristics and comorbid mental and physical disorders. Patients with both diabetes and eating disorders had significantly higher levels of comorbid anxiety, panic attacks, and alcohol use disorders, compared with those with one but not both.
  
  
  CONCLUSIONS
  Consistent with reports from community-based samples, these data suggest that diabetes may be associated with an increased likelihood of eating disorders among patients in primary care. Clinicians who treat patients with diabetes, a common condition in primary care, should screen for eating disorders. In addition, patients with eating disorders may be at risk for the development of diabetes. Further work is needed to determine the generalizability of these findings and to understand the mechanism of this association.
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York 10032, USA. rdg66@columbia.edu
authors.forename: Renee D
authors.initials: RD
authors.lastname: Goodwin
authors.forename: Christina W
authors.initials: CW
authors.lastname: Hoven
authors.forename: Robert L
authors.initials: RL
authors.lastname: Spitzer
mesh_terms: D000328:Adult; D003710:Demography; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000523:psychology; D001068:Feeding and Eating Disorders / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D015995:Prevalence; D011320:Primary Health Care; D012649:Self Concept; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D011795:Surveys and Questionnaires