title: Reliability of self-reported eating disorders: Optimizing population screening.
abstract: OBJECTIVE
  The objective of this study was to assess whether short self-report eating disorder screening questions are useful population screening methods.
  
  
  METHODS
  We screened the female participants (N = 2881) from the 1975-1079 birth cohorts of Finnish twins for eating disorders, using several short screening questions and three Eating Disorder Inventory (EDI) subscales. Comparing these measures with clinician-conducted semi-structured diagnostic interviews (N = 549) of Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) anorexia and bulimia, we calculated their sensitivities and specificities and drew receiver operating characteristic curves to further compare these items.
  
  
  RESULTS
  For current and lifetime bulimia, best tradeoffs between sensitivity and specificity were reached by addressing purging behaviors. For current and lifetime anorexia, the questions "Have you ever had anorexia" and "Has anybody ever suspected that you might have an eating disorder?" optimized tradeoffs between sensitivity and specificity. These questions generally outperformed EDI subscales.
  
  
  CONCLUSIONS
  Simple screening questions, although less than ideal, are at least as good as other available instruments for community screenings.
authors.affiliation: Department of Epidemiology, Columbia University, New York, New York 10032, USA. anna.keski-rahkonen@helsinki.fi
authors.forename: Anna
authors.initials: A
authors.lastname: Keski-Rahkonen
authors.forename: Elina
authors.initials: E
authors.lastname: Sihvola
authors.forename: Anu
authors.initials: A
authors.lastname: Raevuori
authors.forename: Jutta
authors.initials: J
authors.lastname: Kaukoranta
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Bulik
authors.forename: Hans W
authors.initials: HW
authors.lastname: Hoek
authors.forename: Aila
authors.initials: A
authors.lastname: Rissanen
authors.forename: Jaakko
authors.initials: J
authors.lastname: Kaprio
mesh_terms: D000328:Adult; D039721:Diagnostic and Statistical Manual of Mental Disorders; D001068:Feeding and Eating Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D005387:Finland; D006801:Humans; D008137:Longitudinal Studies; D008403:Mass Screening / Q000379:methods*; D015203:Reproducibility of Results; D012650:Self Disclosure; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014427:Twins / Q000523:psychology