title: Eating disorder diagnoses in general practice settings: comparison with structured clinical interview and self-report questionnaires.
abstract: BACKGROUND
  Accurate diagnosis of eating disorders may facilitate appropriate management of the conditions. Currently, little information is available regarding the accuracy of eating disorder diagnoses made in routine primary care.
  
  
  OBJECTIVE
  To evaluate the accuracy of eating disorder diagnoses made in primary care settings, and to compare the accuracy of primary care diagnoses with those generated using patient self-report questionnaires.
  
  
  METHODS
  Participants were 212 consecutive referrals to an outpatient eating disorder programme, who were found to have a DSM-IV eating disorder upon assessment with the Eating Disorder Examination (EDE). Primary care diagnoses were taken from referral letters and forms. Self-report diagnoses were generated using self-report responses to the Eating Disorder Examination-Questionnaire (EDE-Q).
  
  
  RESULTS
  Primary care practitioners were accurate in identifying anorexia and bulimia nervosa, but inaccurate in identifying atypical presentations (e.g. eating disorders not otherwise specified [EDNOS]). Convergence between the EDE and the EDE-Q was modest, and the EDE-Q tended to overestimate the incidence of EDNOS.
  
  
  CONCLUSIONS
  'Atypical' eating disorder presentations tend to be misdiagnosed in primary care settings, although practitioners are generally accurate in distinguishing between anorexia-like and bulimia-like presentations. This has implications for the management of eating disorders in primary care settings.
authors.affiliation: Centre for Clinical Interventions, Northbridge, Western Australia, Australia. karina.allen@uwa.edu.au
authors.forename: Karina L
authors.initials: KL
authors.lastname: Allen
authors.forename: Anthea
authors.initials: A
authors.lastname: Fursland
authors.forename: Hunna
authors.initials: H
authors.lastname: Watson
authors.forename: Susan M
authors.initials: SM
authors.lastname: Byrne
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000856:Anorexia Nervosa / Q000175:diagnosis; D052018:Bulimia Nervosa / Q000175:diagnosis; D003951:Diagnostic Errors; D001068:Feeding and Eating Disorders / Q000175:diagnosis*; D005260:Female; D058006:General Practice; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D014904:Western Australia