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一般从业医师和精神保健在具有神经性贪食症、暴食障碍和其他饮食障碍诊断阈限症状的社区人群中的应用。

General practitioner and mental healthcare use in a community sample of people with diagnostic threshold symptoms of bulimia nervosa, binge-eating disorder, and other eating disorders.

机构信息

Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Campbelltown, Australia.

Campbelltown Hospital, SWSLHD, Campbelltown, Australia.

出版信息

Int J Eat Disord. 2020 Jan;53(1):61-68. doi: 10.1002/eat.23174. Epub 2019 Oct 8.

Abstract

OBJECTIVE

Lengthy delays in receiving treatment have been reported for people with bulimia nervosa (BN) and binge-eating disorder (BED). This study aimed to investigate healthcare use and predictors of mental health specialist healthcare use in a community sample of individuals with diagnostic threshold symptoms of BN, BED-Broad, or another eating disorder (Other ED).

METHOD

In 2017, 2,977 individuals aged ≥15 years were interviewed in a general population survey. Participants were asked questions relating to sociodemographic, ED symptoms, other clinical features, and healthcare use data. Assessment of ED symptoms was based on diagnostic questions derived from the eating disorder examination.

RESULTS

Thirty-six participants with symptoms of BN, 33 participants with BED-Broad, and 369 with an Other ED were identified. Fewer people with symptoms of BN/BED-Broad (23%) or an Other ED (6%) had treatment from a mental health specialist than from a general practitioner (GP; 80%, 71.6%). Healthcare use differed significantly across type of ED only for treatment from a mental health specialist. In multivariate analyses, being asked about a person's mental health by a GP was the best explanatory variable for receiving treatment from a mental health specialist.

DISCUSSION

A large treatment gap exists in healthcare for people with EDs. Inquiry about an individual's mental health by a GP was associated with higher rates of treatment from mental health specialists. However, a similar diet/eating inquiry did not have this association. Future research should consider the use of this patient and practitioner consultation in targeting improved detection of EDs.

摘要

目的

据报道,暴食症(BN)和暴食障碍(BED)患者在接受治疗时会经历长时间的延迟。本研究旨在调查社区样本中具有 BN、BED-广泛或其他饮食障碍(Other ED)诊断阈症状的个体的医疗保健使用情况和心理健康专家医疗保健使用的预测因素。

方法

在 2017 年,对 2977 名年龄≥15 岁的个体进行了一项一般人群调查。参与者被问及与社会人口统计学、ED 症状、其他临床特征和医疗保健使用数据相关的问题。ED 症状的评估基于源自饮食障碍检查的诊断问题。

结果

确定了 36 名具有 BN 症状的参与者、33 名具有 BED-广泛症状的参与者和 369 名具有其他 ED 症状的参与者。具有 BN/BED-广泛症状(23%)或其他 ED 症状(6%)的人接受心理健康专家治疗的人数少于接受全科医生(GP;80%,71.6%)治疗的人数。仅在接受心理健康专家治疗方面,医疗保健的使用在不同类型的 ED 之间存在显著差异。在多变量分析中,GP 询问一个人的心理健康状况是接受心理健康专家治疗的最佳解释变量。

讨论

在 ED 的医疗保健中存在巨大的治疗差距。GP 询问个体的心理健康状况与接受心理健康专家治疗的比例较高相关。然而,类似的饮食/进食咨询没有这种关联。未来的研究应考虑在目标设定中使用这种医患咨询,以提高 ED 的检出率。

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