Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan.
The Center for Eating Disorders, Ann Arbor, Michigan.
Int J Eat Disord. 2019 Nov;52(11):1281-1290. doi: 10.1002/eat.23140. Epub 2019 Jul 19.
This study describes the prevalence of eating disorders among adult patients who present to the emergency department for medical care and examines the relationship between eating disorders, depression, and substance use disorders.
Emergency department patients aged 21-65 years (n = 1,795) completed a computerized questionnaire that included validated screening tools for eating disorders, risky drinking behavior, other substance use, and depression. Analyses were conducted comparing individuals who screened positive for an eating disorder with those who did not based on demographics (gender, age, race, income, education), body mass index (BMI), risky drinking behavior, other substance use, and depression.
Nearly 16% (15.9%) of all patients screened positive for an eating disorder regardless of their reason for presenting to the emergency department. Patients who screened positive for an eating disorder were significantly more likely to have a BMI > 30 (odds ratio [OR] = 2.68, confidence interval [CI] = 1.98, 3.62, p < .001), to also screen positive for depression (OR = 3.19, CI = 2.28, 4.47, p < .001) and to be female (OR = 2.37, CI = 1.76, 3.19, p < .001). No differences in the prevalence of positive screens for eating disorders were seen across age or racial groups, level of education or income, or for any of the included substance use variables.
Eating disorders are common among adult emergency department patients and are associated with high rates of comorbid depression and higher BMI. Given the significant morbidity and mortality associated with eating disorders, targeted screening may be warranted in the emergency department setting.
本研究描述了在因医疗就诊而前往急诊部的成年患者中进食障碍的患病率，并探讨了进食障碍、抑郁和物质使用障碍之间的关系。
21-65 岁的急诊部患者（n=1795）完成了一份计算机化问卷，其中包括用于进食障碍、危险饮酒行为、其他物质使用和抑郁的经验证的筛查工具。根据人口统计学特征（性别、年龄、种族、收入、教育程度）、体重指数（BMI）、危险饮酒行为、其他物质使用和抑郁情况，对筛查出进食障碍阳性的个体与未筛查出的个体进行了比较。
无论就诊原因如何，近 16%（15.9%）的患者筛查出进食障碍。筛查出进食障碍的患者更有可能 BMI＞30（比值比 [OR] = 2.68，置信区间 [CI] = 1.98，3.62，p＜.001），同时也更有可能筛查出抑郁（OR = 3.19，CI = 2.28，4.47，p＜.001），且更可能为女性（OR = 2.37，CI = 1.76，3.19，p＜.001）。在年龄或种族群体、教育程度或收入水平、或任何包括的物质使用变量方面，进食障碍筛查阳性的发生率没有差异。
进食障碍在成年急诊部患者中较为常见，与高比例的共病性抑郁和更高的 BMI 相关。鉴于进食障碍与显著的发病率和死亡率相关，在急诊部环境中可能需要进行有针对性的筛查。
