Screening, assessment and diagnosis in the eating disorders: findings from a rapid review (2024)

Screening, assessment and diagnosis in the eating disorders: findings from a rapid review (1) https://doi.org/10.1186/s40337-022-00597-8 · Screening, assessment and diagnosis in the eating disorders: findings from a rapid review (2)

Видання: Journal of Eating Disorders, 2022, №1

Видавець: Springer Science and Business Media LLC

Автори:

  1. Emma Bryant
  2. Karen Spielman
  3. Anvi Le
  4. Peta Marks
  5. Phillip Aouad
  6. Sarah Barakat
  7. Robert Boakes
  8. Leah Brennan
  9. Emma Bryant
  10. Susan Byrne
  11. Belinda Caldwell
  12. Shannon Calvert
  13. Bronny Carroll
  14. David Castle
  15. Ian Caterson
  16. Belinda Chelius
  17. Lyn Chiem
  18. Simon Clarke
  19. Janet Conti
  20. Lexi Crouch
  21. Genevieve Dammery
  22. Natasha Dzajkovski
  23. Jasmine Fardouly
  24. John Feneley
  25. Nasim Foroughi
  26. Mathew Fuller-Tyszkiewicz
  27. Anthea Fursland
  28. Veronica Gonzalez-Arce
  29. Bethanie Gouldthorp
  30. Kelly Griffin
  31. Scott Griffiths
  32. Ashlea Hambleton
  33. Amy Hannigan
  34. Mel Hart
  35. Susan Hart
  36. Phillipa Hay
  37. Ian Hickie
  38. Francis Kay-Lambkin
  39. Ross King
  40. Michael Kohn
  41. Eyza Koreshe
  42. Isabel Krug
  43. Anvi Le
  44. Jake Linardon
  45. Randall Long
  46. Amanda Long
  47. Sloane Madden
  48. Sarah Maguire
  49. Danielle Maloney
  50. Peta Marks
  51. Sian McLean
  52. Thy Meddick
  53. Jane Miskovic-Wheatley
  54. Deborah Mitchison
  55. Richard O’Kearney
  56. Roger Paterson
  57. Susan Paxton
  58. Melissa Pehlivan
  59. Genevieve Pepin
  60. Andrea Phillipou
  61. Judith Piccone
  62. Rebecca Pinkus
  63. Bronwyn Raykos
  64. Paul Rhodes
  65. Elizabeth Rieger
  66. Sarah Rodan
  67. Karen Rockett
  68. Janice Russell
  69. Haley Russell
  70. Fiona Salter
  71. Susan Sawyer
  72. Beth Shelton
  73. Urvashnee Singh
  74. Sophie Smith
  75. Evelyn Smith
  76. Karen Spielman
  77. Sarah Squire
  78. Juliette Thomson
  79. Marika Tiggemann
  80. Stephen Touyz
  81. Ranjani Utpala
  82. Lenny Vartanian
  83. Andrew Wallis
  84. Warren Ward
  85. Sarah Wells
  86. Eleanor Wertheim
  87. Simon Wilksch
  88. Michelle Williams
  89. Stephen Touyz
  90. Sarah Maguire
  91. 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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