[Primary care and eating disorders: our attitude towards them (I)]

[Detection of adolescents at risk of suffering eating disorders]

OBJECTIVES

To analyse which risk factors are related to eating disorders and to identify useful questions for their early detection in primary care.

DESIGN

Observational, cross-sectional study.

SETTING

Six secondary schools in Leganés, Madrid, Spain.

PARTICIPANTS

Adolescents aged between 12 and 18 years old attending secondary school.

MAIN MEASUREMENTS

Risk of suffering an eating disorder (Eating Attitudes Test-26) and questions about weight, height, family, attitudes towards body image, use of health services for eating disorders, and mental illness history.

RESULTS

An 8.8% of the adolescents were at risk of developing an eating disorder (4.6% male; 11.8% female). Age in males (OR=0.76) and 24-hour fasting to lose weight (OR for males =7.44; OR for females =3.09) were associated with the risk of eating disorders. Early menarche (OR=1.69), having dieted for social or environmental reasons, and self-induced vomiting (OR=5.71) were associated with eating disorders in women. The specificity and negative predictive value of asking about self-induced vomiting and 24-hour fasting in order to detect an eating disorder were around 95%.

CONCLUSIONS

Age is a protective factor for eating disorders, especially in males. In women, early menarche is a risk factor. Asking about self-induced vomiting and 24-hour fasting enables eating disorders in women to be ruled out.

[Validation of the SCOFF questionnaire for screening the eating behaviour disorders of adolescents in school]

OBJECTIVE

To determine the internal consistency and criteria validity of the SCOFF questionnaire for screening adolescent eating behaviour disorders.

DESIGN

Validation study with stochastic sampling.

SETTING

Three schools at Bucaramanga, Colombia.

PARTICIPANTS

241 students selected at random from 1595 possible ones.

MAIN INTERVENTIONS

SCOFF questionnaire and semi-structured CIDI interview, administered independently.

MAIN MEASUREMENTS

Social and personal details, Cronbach's alpha, sensitivity analysis, specificity, forecast values, Cohen mean kappa test, and ROC curve.

RESULTS

Sensitivity found was 81.9% (95% CI, 70.7-89.7) and specificity, 78.7% (95% CI, 71.7-84.6). The area under the ROC curve was 0.8596 (95% CI, 0.8108-0.9084); the Cronbach's alpha test, 0.436, and the Cohen mean kappa, 0.554 (95% CI, 0.425-0.683).

CONCLUSIONS

The SCOFF questionnaire is an acceptable alternative for screening groups of adolescents because of its simplicity and speed of administration.