The Demand for Eating Disorder Care

BACKGROUND An epidemiological study of anorexia nervosa and bulimia nervosa in primary care was performed using the General Practice Research Database (GPRD). METHOD The GPRD was screened between 1988 and 1994 for newly diagnosed cases of anorexia nervosa and bulimia nervosa. The validity of the computer diagnosis was established by obtaining clinical details from a random sample of the general practitioners (GPs). RESULTS Incidence rates for detection of cases by GPs in 1993 was 4.2 per 100,000 population for anorexia nervosa, and 12.2 per 100,000 for bulimia nervosa. The relative risks of females to males was 40:1 for anorexia nervosa and 47:1 for bulimia nervosa. A threefold increase in the recording of bulimia nervosa was found from 1988 to 1993. Eighty per cent of anorexia nervosa cases and 60% of bulimia nervosa cases were referred to secondary care. CONCLUSION There is a continuing expansion of service need for bulimia nervosa. The majority of cases of eating disorders are referred to secondary services. There is scope for more effective management of bulimia nervosa in primary care.

[1]  Eric Fombonne.  Anorexia Nervosa , 1995, British Journal of Psychiatry.

[2]  S. Nielsen.  The epidemiology of anorexia nervosa in Denmark from 1973 to 1987: a nationwide register study of psychiatric admission , 1990, Acta psychiatrica Scandinavica.

[3]  B. Arnow,et al.  One-year follow-up of psychosocial and pharmacologic treatments for bulimia nervosa. , 1994, The Journal of clinical psychiatry.

[4]  G Russell,et al.  Bulimia nervosa: an ominous variant of anorexia nervosa , 1979, Psychological Medicine.

[5]  L. Melton,et al.  Bulimia nervosa in Rochester, Minnesota from 1980 to 1990 , 1995, Psychological Medicine.

[6]  M. King,et al.  THE "EPIDEMIC" OF ANOREXIA NERVOSA: ANOTHER MEDICAL MYTH? , 1987, The Lancet.

[7]  P. Joyce,et al.  Hospitalization for anorexia nervosa , 1992 .

[8]  R. Kessler,et al.  The genetic epidemiology of bulimia nervosa. , 1991, The American journal of psychiatry.

[9]  W. O'Fallon,et al.  50-year trends in the incidence of anorexia nervosa in Rochester, Minn.: a population-based study. , 1991, The American journal of psychiatry.

[10]  H. Hoek,et al.  Impact of urbanization on detection rates of eating disorders. , 1995, The American journal of psychiatry.

[11]  G. Szmukler,et al.  Anorexia nervosa: a psychiatric case register study from Aberdeen , 1986, Psychological Medicine.

[12]  A. K. Pagsberg,et al.  Epidemiology of anorexia nervosa and bulimia nervosa in Bornholm County, Denmark, 1970–1989 , 1994, Acta psychiatrica Scandinavica.

[13]  H. Hoek,et al.  The incidence and prevalence of anorexia nervosa and bulimia nervosa in primary care , 1991, Psychological Medicine.

[14]  J. Treasure,et al.  Sequential Treatment for Bulimia Nervosa Incorporating A Self-Care Manual , 1996, British Journal of Psychiatry.

[15]  H. Hoek,et al.  Review of the epidemiological studies of eating disorders. , 1993 .

[16]  P. Joyce,et al.  Prevalence of three bulimia syndromes in the general population , 1990, Psychological Medicine.

[17]  U. Schmidt,et al.  First step in managing bulimia nervosa: controlled trial of therapeutic manual , 1994 .

[18]  Janet Treasure,et al.  A Practical Guide to the Use of Motivational Interviewing in Anorexia Nervosa , 1997 .

[19]  E. Fombonne.  Is bulimia nervosa increasing in frequency? , 1996, The International journal of eating disorders.