https://doi.org/10.1186/s40337-022-00597-8 ·
Видання: Journal of Eating Disorders, 2022, №1
Видавець: Springer Science and Business Media LLC
Автори:
- Emma Bryant
- Karen Spielman
- Anvi Le
- Peta Marks
- Phillip Aouad
- Sarah Barakat
- Robert Boakes
- Leah Brennan
- Emma Bryant
- Susan Byrne
- Belinda Caldwell
- Shannon Calvert
- Bronny Carroll
- David Castle
- Ian Caterson
- Belinda Chelius
- Lyn Chiem
- Simon Clarke
- Janet Conti
- Lexi Crouch
- Genevieve Dammery
- Natasha Dzajkovski
- Jasmine Fardouly
- John Feneley
- Nasim Foroughi
- Mathew Fuller-Tyszkiewicz
- Anthea Fursland
- Veronica Gonzalez-Arce
- Bethanie Gouldthorp
- Kelly Griffin
- Scott Griffiths
- Ashlea Hambleton
- Amy Hannigan
- Mel Hart
- Susan Hart
- Phillipa Hay
- Ian Hickie
- Francis Kay-Lambkin
- Ross King
- Michael Kohn
- Eyza Koreshe
- Isabel Krug
- Anvi Le
- Jake Linardon
- Randall Long
- Amanda Long
- Sloane Madden
- Sarah Maguire
- Danielle Maloney
- Peta Marks
- Sian McLean
- Thy Meddick
- Jane Miskovic-Wheatley
- Deborah Mitchison
- Richard O’Kearney
- Roger Paterson
- Susan Paxton
- Melissa Pehlivan
- Genevieve Pepin
- Andrea Phillipou
- Judith Piccone
- Rebecca Pinkus
- Bronwyn Raykos
- Paul Rhodes
- Elizabeth Rieger
- Sarah Rodan
- Karen Rockett
- Janice Russell
- Haley Russell
- Fiona Salter
- Susan Sawyer
- Beth Shelton
- Urvashnee Singh
- Sophie Smith
- Evelyn Smith
- Karen Spielman
- Sarah Squire
- Juliette Thomson
- Marika Tiggemann
- Stephen Touyz
- Ranjani Utpala
- Lenny Vartanian
- Andrew Wallis
- Warren Ward
- Sarah Wells
- Eleanor Wertheim
- Simon Wilksch
- Michelle Williams
- Stephen Touyz
- Sarah Maguire
- National Eating Disorder Research Consortium
Джерело фінансування: Department of Health, Australian Government
Анотація
Abstract<jats:sec>BackgroundLimited screening practices, minimal eating disorder training in the healthcare professions, and barriers related to help-seeking contribute to persistent low rates of eating disorder detection, significant unmet treatment need, and appreciable associated disease burden. The current review sought to broadly summarise the literature and identify gaps relating to the screening, assessment, and diagnosis of eating disorders within Western healthcare systems.</jats:sec><jats:sec>MethodsThis paper forms part of a Rapid Review series scoping the evidence base for the field of eating disorders, conducted to inform the Australian National Eating Disorders Research and Translation Strategy 2021–2031, funded and released by the Australian Government. ScienceDirect, PubMed and Ovid/Medline were searched for studies published between 2009 and mid 2021 in English. High-level evidence such as meta-analyses, large population studies and Randomised Control Trials were prioritised through purposive sampling. Data from selected studies relating to Screening, Assessment and Diagnosis of eating disorders were synthesised and are disseminated in the current review.</jats:sec><jats:sec>ResultsEighty seven studies were identified, 38% relating to screening and 62% to assessment and diagnosis. The majority of screening studies were conducted in university student samples, showing high prevalence but only modest improvements in help-seeking in those studies that followed up post-screen. In healthcare settings, clinicians continue to have difficulty identifying eating disorder presentations, particularly Binge Eating Disorder, Other Specified Feeding or Eating Disorders, and sub-threshold eating disorders. This is preceded by inadequate and frequently homogenous screening mechanisms and exacerbated by considerable personal and health-system barriers, including self-stigma and lack of resourcing. While all groups are at risk of delayed or no diagnosis, those at particular risk include LGBTQ+ and gender diverse individuals, individuals living in larger bodies, and males.</jats:sec><jats:sec>ConclusionsA majority of individuals with eating disorders remain undiagnosed and untreated despite a high prevalence of these conditions and increased advocacy in recent years. Research into improving detection and clinician diagnostic skill is extremely limited. Innovative empirical research is strongly recommended to address significant individual and health-system barriers currently preventing appropriate and timely intervention for many.</jats:sec><jats:sec>Plain English SummaryLimited screening in healthcare settings and low rates of eating disorder training in the healthcare professions are just some of the barriers to help-seeking which may contribute to delayed intervention and diagnosis in the eating disorders. This has significant impacts, prolonging treatment when it is finally received, and increasing healthcare costs for both the individual and the healthcare system. The current review is part of a larger Rapid Review series conducted to inform the development of Australia’s National Eating Disorders Research and Translation Strategy 2021–2031. A Rapid Review is designed to comprehensively summarise a body of literature in a short timeframe, often to guide policy-making and address urgent health concerns. The Rapid Review synthesises the current evidence-base and identifies gaps in eating disorder research and care, in order to guide decision making and address urgent health concerns. This paper gives a critical overview of the scientific literature relating to the current state of screening, assessment, and diagnosis of eating disorders within Western healthcare systems that may inform health policy and research in an Australian context. It covers screening initiatives in both general and high-risk populations; personal, clinician and healthcare system challenges relating to help-seeking; and obstacles to accurate and timely clinical diagnosis across the eating disorders.</jats:sec>
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