title: Diagnosing and managing anorexia nervosa in UK primary care: a focus group study.
abstract: BACKGROUND
  Anorexia is a leading cause of adolescent hospital admission and death from psychiatric disorder. Despite the potential role of general practitioners in diagnosis, appropriate referral and coordinating treatment, few existing studies provide fine-grained accounts of GPs' beliefs about anorexia.
  
  
  OBJECTIVE
  To identify GPs' understandings and experiences of diagnosing and managing patients with anorexia in primary care.
  
  
  METHODS
  Case-based focus groups with co-working general practitioners in the East Midlands region of England were used to explore attitudes towards issues common to patients with eating disorders. Group discussions were transcribed and analysed using corpus linguistic and discourse analytic approaches.
  
  
  RESULTS
  Participants' discussion focused on related issues of making hesitant diagnoses, the utility of the body mass index, making referrals and overcoming patient resistance. Therapeutic relationships with patients with anorexia are considered highly complex, with participants using diagnostic tests as rhetorical strategies to help manage communicative obstacles.
  
  
  CONCLUSIONS
  Overcoming patient repudiation and securing referrals are particular challenges with this patient group. Successfully negotiating these problems appears to require advanced communication skills.
authors.affiliation: School of English, University of Nottingham, Nottingham NG7 2RD, UK. daniel.hunt@nottingham.ac.uk
authors.forename: D
authors.initials: D
authors.lastname: Hunt
authors.forename: R
authors.initials: R
authors.lastname: Churchill
mesh_terms: D000328:Adult; D000856:Anorexia Nervosa / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D001291:Attitude of Health Personnel; D015992:Body Mass Index; D019468:Disease Management; D005260:Female; D017144:Focus Groups; D058005:General Practitioners / Q000523:psychology*; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000379:methods / Q000592:standards; D011369:Professional-Patient Relations; D036301:Qualitative Research; D012017:Referral and Consultation / Q000458:organization & administration; D006113:United Kingdom
keywords: Anorexia; body mass index; corpus linguistics; focus groups; primary care.