scholarly journals Three decades of eating disorders in Dutch primary care: decreasing incidence of bulimia nervosa but not of anorexia nervosa

2015 ◽  
Vol 46 (6) ◽  
pp. 1189-1196 ◽  
Author(s):  
F. R. E. Smink ◽  
D. van Hoeken ◽  
G. A. Donker ◽  
E. S. Susser ◽  
A. J. Oldehinkel ◽  
...  
Keyword(s):  
Primary Care ◽  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Health Insurance ◽  
The Netherlands ◽  
Bulimia Nervosa ◽  
Incidence Rate ◽  
Mental Healthcare ◽  
Incidence Rates ◽  
The Past

BackgroundWhether the incidence of eating disorders in Western, industrialized countries has changed over time has been the subject of much debate. The purpose of this primary-care study was to examine changes in the incidence of eating disorders in The Netherlands during the 1980s, 1990s and 2000s.MethodA nationwide network of general practitioners (GPs), serving a representative sample (~1%) of the total Dutch population, recorded newly diagnosed patients with anorexia nervosa (AN) and bulimia nervosa (BN) in their practice during 1985–1989, 1995–1999, and 2005–2009. GPs are key players in the Dutch healthcare system, as their written referral is mandatory in order to get access to specialized (mental) healthcare, covered by health insurance. Health insurance is virtually universal in The Netherlands (99% of the population). A substantial number of GPs participated in all three study periods, during which the same case identification criteria were used and the same psychiatrist was responsible for making the final diagnoses. Incidence rates were calculated and for comparison between periods, incidence rate ratios.ResultsThe overall incidence rate of BN decreased significantly in the past three decades (from 8.6 per 100 000 person-years in 1985–1989 to 6.1 in 1995–1999, and 3.2 in 2005–2009). The overall incidence of AN remained fairly stable during three decades, i.e. 7.4 per 1 00 000 person-years in 1985–1989, 7.8 in 1995–1999, and 6.0 in 2005–2009.ConclusionsThe incidence rate of BN decreased significantly over the past three decades, while the overall incidence rate of AN remained stable.

Integrated Care for Binge Eating and Other Eating Disorders

2017 ◽  
Author(s):  
Joel Yager ◽  
Philip S. Mehler ◽  
Eileen D. Yager ◽  
Alison R. Yager
Keyword(s):  
Primary Care ◽  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Bulimia Nervosa ◽  
Binge Eating ◽  
Binge Eating Disorder ◽  
Adolescent Medicine ◽  
Care Practice ◽  
Levels Of Care

Binge eating disorder, bulimia nervosa, and anorexia nervosa, particularly milder cases, often go unrecognized and untreated in primary care practice settings. Eating disorders are frequently associated with shame, and masked by other prominent physical and psychiatric conditions that demand attention. Among adults, binge eating disorder, the most prevalent of the eating disorders, occurs with increasing frequency, in tandem with higher rates and degrees of obesity, across all age ranges, and in both genders. Bulimia nervosa and anorexia nervosa are more common in females, and although they are most often seen in pediatric and adolescent medicine practices cases, they are also seen in adult practice populations. This chapter describes pathways by which primary care practices can implement integrated and collaborative care treatment programs, likely to benefit large numbers of patients, and effectively coordinate with specialist levels of care, as necessary.

The Demand for Eating Disorder Care

1996 ◽  
Vol 169 (6) ◽  
pp. 705-712 ◽  
Author(s):  
Sue Turnbull ◽  
Anne Ward ◽  
Janet Treasure ◽  
Hershel Jick ◽  
Laura Derby
Keyword(s):  
Primary Care ◽  
Anorexia Nervosa ◽  
Bulimia Nervosa ◽  
General Practice Research Database ◽  
Incidence Rates ◽  
Practice Research ◽  
Research Database ◽  
Effective Management ◽  
Relative Risks ◽  
Service Need

BackgroundAn epidemiological study of anorexia nervosa and bulimia nervosa in primary care was performed using the General Practice Research Database (GPRD).MethodThe GPRD was screened between 1988 and 1994 for newly diagnosed cases of anorexia nervosa and bulimia nervosa. The validity of the computer diagnosis was established by obtaining clinical details from a random sample of the general practitioners (GPs).ResultsIncidence rates for detection of cases by GPs in 1993 was 4.2 per 100 000 population for anorexia nervosa and 12.2 per 100 000 for bulimia nervosa The relative risks of females to males was 40:1 for anorexia nervosa and 47:1 for bulimia nervosa A threefold increase in the recording of bulimia nervosa was found from 1988 to 1993. Eighty per cent of anorexia nervosa cases and 60% of bulimia nervosa cases were referred to secondary care.ConclusionThere is a continuing expansion of service need for bulimia nervosa The majority of cases of eating disorders are referred to secondary services. There is scope for more effective management of bulimia nervosa in primary care.

scholarly journals Urbanisation and the incidence of eating disorders

2006 ◽  
Vol 189 (6) ◽  
pp. 562-563 ◽  
Author(s):  
Gabriëlle E. Van Son ◽  
Daphne Van Hoeken ◽  
Aad I. M. Bartelds ◽  
Eric F. Van Furth ◽  
Hans W. Hoek
Keyword(s):  
Primary Care ◽  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Risk Factor ◽  
Bulimia Nervosa ◽  
Rural Areas ◽  
Urban Areas ◽  
Urban Life ◽  
Environmental Risk Factor ◽  
Promising Avenue

SummaryThe link between degree of urbanisation and a number of mental disorders is well established. Schizophrenia, psychosis and depression are known to occur more frequently in urban areas. In our primary care-based study of eating disorders, the incidence of bulimia nervosa showed a dose–response relation with degree of urbanisation and was five times higher in cities than in rural areas. Remarkably, anorexia nervosa showed no association with urbanisation. We conclude that urban life is a potential environmental risk factor for bulimia nervosa but not for anorexia nervosa. These findings provide a promising avenue for further research into the aetiology of eating disorders.

scholarly journals Epidemiology of eating disorders in primary care in children and young people: a Clinical Practice Research Datalink study in England

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e026691
Author(s):  
Sophie Wood ◽  
Amanda Marchant ◽  
Mark Allsopp ◽  
Kathleen Wilkinson ◽  
Jackie Bethel ◽  
...  
Keyword(s):  
Primary Care ◽  
Eating Disorders ◽  
Clinical Practice ◽  
Incidence Rate ◽  
Secondary Care ◽  
Service Use ◽  
Incidence Rates ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Deprived Areas

ObjectivesExamination of current temporal trends and clinical management patterns of eating disorders (ED) in primary care is lacking. We aimed to calculate annual incidence rates of EDs in primary care by age, sex and deprivation. We also explored the care received through referrals, psychotropic prescriptions and associated secondary care service use.Participants and settingsA retrospective electronic cohort study was conducted using the Clinical Practice Research Datalink in those aged 11–24 years between 2004 and 2014 in England (n=1 135 038).ResultsA total of 4775 individuals with a first ever recorded ED diagnosis were identified. The crude incidence rate was 100.1 per 100 000 person years at risk (95% CI 97.2 to 102.9). Incidence rates were highest in females (189.3 per 100 000 person years, 95% CI 183.7 to 195.0, n=4336), 16–20 years of age (141.0 per 100 000 person years, 95% CI 135.4 to 146.9, n=2348) and individuals from the least deprived areas (115.8 per 100 000 person years (95% CI 109.3 to 122.5, n=1203). Incidence rates decreased across the study period (incidence rate ratio (IRR) 0.6, 95% CI 0.5 to 0.8), particularly for individuals with bulimia nervosa (IRR 0.5, 95% CI 0.3 to 0.7) and from the most deprived areas (IRR 0.5, 95% CI 0.4 to 0.7). A total of 17.4% (95% CI 16.3 to 18.5, n=831) of first ever recorded ED cases were referred from primary to secondary care. 27.1% (95% CI 25.9 to 28.4, n=1294) of individuals had an inpatient admission 6 months before or 12 months after an incident ED diagnosis and 53.4% (95% CI 52.0 to 54.9, n=2550) had an outpatient attendance. Antidepressants were the most commonly prescribed psychotropic medication.ConclusionsNew ED presentations in primary care are reducing. Understanding the cause of this decrease (coding behaviours, changes in help-seeking or a genuine reduction in new cases) is important to plan services, allocate resources and deliver effective care.

The incidence and prevalence of anorexia nervosa and bulimia nervosa in primary care

1991 ◽  
Vol 21 (2) ◽  
pp. 455-460 ◽  
Author(s):  
Hans W. Hoek
Keyword(s):  
Primary Care ◽  
Anorexia Nervosa ◽  
Bulimia Nervosa ◽  
Incidence Rate ◽  
General Practitioners ◽  
Rural Areas ◽  
Representative Sample ◽  
Dutch Population ◽  
Equal Frequency

SYNOPSISGeneral practitioners using DSM-III criteria have studied the incidence and prevalence of anorexia nervosa and bulimia nervosa in a large (N = 151781) representative sample of the Dutch population. The incidence rate for anorexia nervosa is 6·3 and for bulimia nervosa 9·9 per year per 100000 population. The prevalence of bulimia nervosa is three times higher in larger cities than in smaller urbanized or rural areas, while anorexia nervosa is found with almost equal frequency in areas with a different degree of urbanization.

scholarly journals Time trends in eating disorder incidence

2005 ◽  
Vol 186 (2) ◽  
pp. 132-135 ◽  
Author(s):  
Laura Currin ◽  
Ulrike Schmidt ◽  
Janet Treasure ◽  
Hershel Jick
Keyword(s):  
Primary Care ◽  
Anorexia Nervosa ◽  
Bulimia Nervosa ◽  
Service Use ◽  
General Practice Research Database ◽  
Incidence Rates ◽  
Practice Research ◽  
Research Database ◽  
The Stability ◽  
The Uk

BackgroundDuring the years 1988–1993 the primary care incidence of anorexia nervosa in the UK remained stable, but the incidence of bulimia nervosa increased threefold.AimsTo determine whether the incidence of anorexia nervosa remained stable, and that of bulimia nervosa continued to increase, in the years 1994–2000.MethodThe General Practice Research Database was screened for new cases of anorexia and bulimia nervosa between 1994 and 2000. Annual incidence rates were calculated for females aged 10–39 years and compared with rates from the previous 5 years.ResultsIn 2000 primary care incidence rates were 4. 7 and 6. 6 per 100 000 population for anorexia and bulimia nervosa, respectively. The incidence of anorexia nervosa remained remarkably consistent over the period studied. Overall there was an increase in the incidence of bulimia, but rates declined after a peak in 1996.ConclusionsThis study provides further evidence for the stability of anorexia nervosa incidence rates. Decreased symptom recognition and changes in service use might have contributed to observed changes in the incidence of bulimia nervosa.

Pharmacotherapy for Eating Disorders

2017 ◽  
Author(s):  
Susan McElroy ◽  
Anna I. Guerdjikova ◽  
Nicole Mori ◽  
Paul E. Keck
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Mental Disorders ◽  
Bulimia Nervosa ◽  
Binge Eating ◽  
Binge Eating Disorder ◽  
Night Eating Syndrome ◽  
Night Eating

This chapter addresses the pharmacotherapy of the eating disorders (EDs). Many persons with EDs receive pharmacotherapy, but pharmacotherapy research for EDs has lagged behind that for other major mental disorders. This chapter first provides a brief rationale for using medications in the treatment of EDs. It then reviews the data supporting the effectiveness of specific medications or medication classes in treating patients with anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other potentially important EDs, such as night eating syndrome (NES). It concludes by summarizing these data and suggesting future areas for research in the pharmacotherapy of EDs.

Epidemiology and Course of Eating Disorders

2010 ◽  
pp. 24-32 ◽  
Author(s):  
Pamela Keel
Keyword(s):  
Public Health ◽  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Bulimia Nervosa ◽  
The Public ◽  
Purging Disorder ◽  
Not Otherwise Specified ◽  
Public Health Significance ◽  
Health Significance

The epidemiology of eating disorders holds important clues for understanding factors that may contribute to their etiology. In addition, epidemiological findings speak to the public health significance of these deleterious syndromes. Information on course and outcome are important for clinicians to understand the prognosis associated with different disorders of eating and for treatment planning. This chapter reviews information on the epidemiology and course of anorexia nervosa, bulimia nervosa, and two forms of eating disorder not otherwise specified, binge eating disorder and purging disorder.

Pharmacotherapy of the Eating Disorders

2010 ◽  
pp. 416-451 ◽  
Author(s):  
Susan L. McElroy ◽  
Anna I. Guerdjikova ◽  
Anne M. O’Melia ◽  
Nicole Mori ◽  
Paul E. Keck
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Mental Disorders ◽  
Bulimia Nervosa ◽  
Binge Eating ◽  
Binge Eating Disorder ◽  
Night Eating Syndrome ◽  
Night Eating

Many persons with eating disorders (EDs) receive pharmacotherapy, but pharmacotherapy research for EDs has lagged behind that for other major mental disorders. In this chapter, we first provide a brief rationale for using medications in the treatment of EDs. We then review the data supporting the effectiveness of specific medications or medication classes in treating patients with anorexia nervosa (AN), bulimia nervosa, binge eating disorder (BED), and other potentially important EDs, such as night eating syndrome (NES) and sleep-related eating disorder (SRED). We conclude by summarizing these data and suggesting future areas for research in the pharmacotherapy of EDs.

scholarly journals Registration of Blood Exposure Accidents in the Netherlands by a Nationally Operating Call Center

2012 ◽  
Vol 33 (10) ◽  
pp. 1017-1023
Author(s):  
Peter M. Schneeberger ◽  
Annemarie E. Meiberg ◽  
Janet Warmelts ◽  
Sander C. A. P. Leenders ◽  
Paul T. L. van Wijk
Keyword(s):  
The Netherlands ◽  
Call Center ◽  
Preventive Measures ◽  
Healthcare Providers ◽  
Mental Healthcare ◽  
Incidence Rates ◽  
Hepatitis B Vaccination ◽  
Occupational Health Services ◽  
Healthcare Facilities ◽  
Call Center Employees

Objective.Healthcare providers and other employees, especially those who do not work in a hospital, may not easily find help after the occurrence of a blood exposure accident. In 2006, a national call center was established in the Netherlands to fill this gap.Methods.All occupational blood exposure accidents reported to the 24-hours-per-day, 7-days-per-week call center from 2007, 2008, and 2009 were analyzed retrospectively for incidence rates, risk assessment, handling, and preventive measures taken.Results.A total of 2,927 accidents were reported. The highest incidence rates were reported for private clinics and hospitals (68.5 and 54.3 accidents per 1,000 person-years, respectively). Dental practices started reporting incidents frequently after the arrangement of a collective financial agreement with the call center. Employees of ambulance services, midwife practices, and private clinics reported mostly high-risk accidents, whereas penitentiaries frequently reported low-risk accidents. Employees in mental healthcare facilities, private clinics, and midwife practices reported accidents relatively late. The extent of hepatitis B vaccination in mental healthcare facilities, penitentiaries, occupational health services, and cleaning services was low (<70%).Conclusions.The national call center successfully organized the national registration and handling of blood exposure accidents. The risk of blood exposure accidents could be estimated on the basis of this information for several occupational branches. Targeted preventive measures for healthcare providers and other employees at risk can next be developed.Infect Control Hosp Epidemiol 2012;33(10):1017-1023

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