title: Variables influencing presenting symptoms of patients with eating disorders at psychiatric outpatient clinics.
abstract: Eating disorders (EDs) have been underdiagnosed in many clinical settings. This study investigates the influence of clinical characteristics on presenting symptoms of patients with EDs. Psychiatric outpatients, aged 18-45, were enrolled sequentially and received a two-phase survey for EDs in August 2010-January 2013. Their primary reasons for seeking psychiatric help were obtained at their first encounter with outpatient psychiatrists. Patients' clinical and demographic characteristics were compared according to presenting symptoms with or without eating/weight problems. Of 2140 patients, 348 (16.3%) were diagnosed with an ED (22.6% of women and 6.3% of men). The three most common reasons for seeking psychiatric help were eating/weight problems (46.0%), emotional problems (41.3%), and sleep disturbances (19.3%). The multivariate analyses suggest that when patients with EDs presented symptoms that were less related to eating/weight problems, they were significantly more likely to be those having diagnoses other than anorexia nervosa or bulimia nervosa and less severe degree of binge-eating. Further, patients with EDs who demonstrated more impulsive behaviors and poorer functioning were less likely to report their eating problems when visiting psychiatric clinics. Thus, ED should be assessed routinely in patients with complex psychopathology to facilitate comprehensive treatment.
authors.affiliation: Department of Psychiatry, Far Eastern Memorial Hospital, New Taipei City 22060, Taiwan; Department of Psychiatry, National Taiwan University College of Medicine, Taipei 10051, Taiwan; Department of Psychiatry, National Taiwan University Hospital, Taipei 10002, Taiwan. Electronic address: mctseng@ntu.edu.tw.
authors.forename: Mei-Chih Meg
authors.initials: MM
authors.lastname: Tseng
authors.affiliation: Department of Psychiatry, Taipei City Hospital, Songde Branch, Taipei 11080, Taiwan.
authors.forename: Kuan-Yu
authors.initials: KY
authors.lastname: Chen
authors.affiliation: Department of Medical Research, National Taiwan University Hospital, Taipei 10055, Taiwan.
authors.forename: Chin-Hao
authors.initials: CH
authors.lastname: Chang
authors.affiliation: Department of Psychiatry, National Taiwan University College of Medicine, Taipei 10051, Taiwan; Department of Psychiatry, National Taiwan University Hospital, Taipei 10002, Taiwan.
authors.forename: Shih-Cheng
authors.initials: SC
authors.lastname: Liao
authors.affiliation: Department of Psychiatry, National Taiwan University College of Medicine, Taipei 10051, Taiwan; Department of Psychiatry, National Taiwan University Hospital, Taipei 10002, Taiwan.
authors.forename: Hsi-Chung
authors.initials: HC
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities; D000856:Anorexia Nervosa / Q000175:diagnosis; D056912:Binge-Eating Disorder / Q000523:psychology; D001835:Body Weight; D002032:Bulimia; D052018:Bulimia Nervosa / Q000523:psychology; D001068:Feeding and Eating Disorders / Q000523:psychology*; D005260:Female; D000066505:Help-Seeking Behavior; D006801:Humans; D007175:Impulsive Behavior; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010045:Outpatients; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires
keywords: Clinical presentation; Eating disorders; Help-seeking behavior; Impulsive behavior; Psychiatric outpatients; SCOFF questionnaire