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Health services use in eating disorders

Published online by Cambridge University Press:  02 November 2007

R. H. Striegel-Moore ,
L. DeBar ,
G. T. Wilson ,
J. Dickerson ,
F. Rosselli ,
N. Perrin ,
F. Lynch  and
H. C. Kraemer
R. H. Striegel-Moore*
Affiliation:
Department of Psychology, Wesleyan University, Middletown, CT, USA
L. DeBar
Affiliation:
Center for Health Research, Kaiser Permanente NorthWest, Portland, OR, USA
G. T. Wilson
Affiliation:
Department of Psychology, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
J. Dickerson
Affiliation:
Center for Health Research, Kaiser Permanente NorthWest, Portland, OR, USA
F. Rosselli
Affiliation:
Department of Psychology, Manchester Community College, Manchester, CT, USA
N. Perrin
Affiliation:
Center for Health Research, Kaiser Permanente NorthWest, Portland, OR, USA
F. Lynch
Affiliation:
Center for Health Research, Kaiser Permanente NorthWest, Portland, OR, USA
H. C. Kraemer
Affiliation:
Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
*
*Address for correspondence: R. H. Striegel-Moore, Ph.D., Department of Psychology, Wesleyan University, 207 High Street, Middletown, CT 06459-0408, USA. (Email: rstriegel@wesleyan.edu)
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Abstract

Background

This study examined healthcare services used by adults diagnosed with an eating disorder (ED) in a large health maintenance organization in the Pacific Northwest.

Method

Electronic medical records were used to collect information on all out-patient and in-patient visits and medication dispenses, from 2002 to 2004, for adults aged 18–55 years who received an ED diagnosis during 2003. Healthcare services received the year prior to, and following, the receipt of an ED diagnosis were examined. Cases were matched to five comparison health plan members who had a health plan visit close to the date of the matched case's ED diagnosis.

Results

Incidence of EDs (0.32% of the 104 130 females, and 0.02% of the 93 628 males) was consistent with prior research employing treatment-based databases, though less than community-based samples. Most cases (50%) were first identified during a primary-care visit and psychiatric co-morbidity was high. Health services use was significantly elevated in all service sectors among those with an ED when compared with matched controls both in the year preceding and that following the receipt of the incident ED diagnosis. Contrary to expectations, healthcare utilization was found to be similarly high across the spectrum of EDs (anorexia nervosa, bulimia nervosa, and eating disorders not otherwise specified).

Conclusions

The elevation in health service use among women both before and after diagnosis suggests that EDs merit identification and treatment efforts commensurate with other mental health disorders (e.g. depression) which have similar healthcare impact.

Keywords

Co-morbidityeating disordershealth services
Type
Original Articles
Information
Psychological Medicine , Volume 38 , Issue 10 , October 2008 , pp. 1465 - 1474
Copyright
Copyright © 2007 Cambridge University Press

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References

Alonso, J, Codony, M, Kovess, V, Angermeyer, MC, Katz, SJ, Haro, JM, De Girolamo, G, De Graaf, R, Demyttenaere, K, Vilagut, G, Almansa, J, Lepine, JP, Brugha, TS, the ESEMeD/MHEDEA 2000 Investigators (2007). Population level of unmet need for mental healthcare in Europe. British Journal of Psychiatry 190, 299–306.CrossRefGoogle ScholarPubMed
Berkman, ND, Bulik, CM, Brownley, KA, Lohr, KN, Sedway, JA, Rooks, A, Gartlehner, G (2006). Management of Eating Disorders. Evidence report/technology assessment no. 135. Prepared by the RTI International-University of North Carolina Evidence-Based Practice Center under contract no. 290-02-0016. Agency for Healthcare Research and Quality Publication no. 06-E010. Agency for Healthcare Research and Quality Publication: Rockville, MD.Google ScholarPubMed
Bruch, H (1978). The Golden Cage. Harvard University Press: Cambridge, MA.Google Scholar
Cachelin, FM, Striegel-Moore, RH (2006). Help seeking and barriers to treatment in a community sample of Mexican American and European American women with eating disorders. International Journal of Eating Disorders 39, 154–161.CrossRefGoogle Scholar
Fairburn, CG, Bohn, K (2005). Eating disorder NOS (EDNOS): an example of the troublesome ‘not otherwise specified’ (NOS) category in DSM-IV. Behavior Research and Therapy 43, 691–701.CrossRefGoogle ScholarPubMed
Freeborn, DK, Pope, CR (1994). Promise and Performance in Managed Care: The Prepaid Group Practice Model. Johns Hopkins University Press: Baltimore, MD.CrossRefGoogle Scholar
Garvin, V, Striegel-Moore, RH (2001). Health services research for eating disorders in the United States: a status report and a call to action. In Eating Disorders: Innovative Directions in Research and Practice (ed. Striegel-Moore, R. H. and Smolak, L.), pp. 135–152. American Psychological Association: Washington, DC.CrossRefGoogle Scholar
Hoek, HW (2006). Incidence, prevalence and mortality of anorexia nervosa and other eating disorders. Current Opinion in Psychiatry 19, 389–394.CrossRefGoogle ScholarPubMed
Hudson, JI, Hiripi, E, Pope, HG Jr, Kessler, RC (2007). The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biological Psychiatry 61, 348–358.CrossRefGoogle ScholarPubMed
Kendler, KS, MacLean, C, Neale, M, Kessler, R, Heath, A, Eaves, L (1991). The genetic epidemiology of bulimia nervosa. American Journal of Psychiatry 148, 1627–1637.Google ScholarPubMed
Kessler, CR, Demler, O, Frank, RG, Olfson, M, Pincus, HA, Walters, EE, Wang, P, Wells, KB, Zaslavsky, AM (2005). Prevalence and treatment of mental disorders 1990 to 2003. The New England Journal of Medicine 352, 2515–2523.CrossRefGoogle ScholarPubMed
Kraemer, HC (1995). Statistical issues in assessing comorbidity. Statistics in Medicine 14, 721–733.CrossRefGoogle ScholarPubMed
Kraemer, HC, Kupfer, DJ (2006). Size of treatment effects and their importance to clinical research and practice. Biological Psychiatry 59, 990–996.CrossRefGoogle ScholarPubMed
Kraemer, HC, Wilson, KA, Hayward, C (2006). Lifetime prevalence and pseudocomorbidity in psychiatric research. Archives of General Psychiatry 63, 604–608.CrossRefGoogle ScholarPubMed
Krauth, C, Buser, K, Vogel, H (2002). How high are the costs of eating disorders – anorexia nervosa and bulimia nervosa – for German society? European Journal of Health Economy 3, 244–250.CrossRefGoogle ScholarPubMed
Lewinsohn, PM, Hops, H, Roberts, RE, Seeley, JR, Andrews, JA (1993). Adolescent psychopathology: I. Prevalence and incidence of depression and other DSM-III-R disorders in high school students. Journal of Abnormal Psychology 102, 133–144.CrossRefGoogle ScholarPubMed
Marshall, R, Grayson, D, Jorm, A, O'Toole, B (2001). Are survey measures of medical care utilisation misleading? A comparison of self-reported medical care consumption with actual medical care utilisation. Australian Health Review 24, 91–99.CrossRefGoogle ScholarPubMed
Martin, A, Leslie, D (2003). Psychiatric inpatient, outpatient, and medication utilization and costs among privately insured youths, 1997–2000. American Journal of Psychiatry 160, 757–764.CrossRefGoogle ScholarPubMed
Mathers, C, Vos, T, Stevenson, C (1999). The Burden of Disease and Injury in Australia. AIHW catalogue no. PHE 17. Australian Institute of Heath and Welfare: Canberra.Google Scholar
Simon, J, Schmidt, U, Pilling, S (2005). The health service use and cost of eating disorders. Psychological Medicine 35, 1543–1551.CrossRefGoogle ScholarPubMed
Spitzer, RL, Kroenke, K, Williams, JBW, the Patient Health Questionnaire Primary Care Study Group (1999). Validation and utility of a self-report version of PRIME-MD: The PHQ Primary Care Study. Journal of the American Medical Association 282, 1737–1744.CrossRefGoogle ScholarPubMed
Stice, E, Telch, CF, Rizvi, SL (2000). Development and validation of the Eating Disorder Diagnostic Scale: a brief self-report measure of anorexia, bulimia, and binge-eating disorder. Psychological Assessment 12, 123–131.CrossRefGoogle Scholar
Striegel-Moore, RH (2005). Health services research in anorexia nervosa. International Journal of Eating Disorders 37 (Suppl.), S31–S34.CrossRefGoogle ScholarPubMed
Striegel-Moore, RH, Leslie, D, Petrill, SA, Garvin, V, Rosenheck, RA (2000). One-year use and cost of inpatient and outpatient services among female and male patients with an eating disorder: evidence from a national database of health insurance claims. International Journal of Eating Disorders 27, 381–389.3.0.CO;2-U>CrossRefGoogle ScholarPubMed
Walters, EE, Kendler, KS (1995). Anorexia nervosa and anorexic-like syndromes in a population-based female twin sample. American Journal of Psychiatry 152, 64–71.Google Scholar
Wang, PS, Lane, M, Olfson, M, Pincus, HA, Wells, KB, Kessler, RC (2005). Twelve-month use of mental health services in the United States: results from the National Comorbidity Survey Replication. Archives of General Psychiatry 62, 629–640.CrossRefGoogle ScholarPubMed
Wilson, TG, Shafran, R (2005). Eating disorders guidelines from NICE. Lancet 365, 79–81.CrossRefGoogle ScholarPubMed
Wonderlich, SA, Mitchell, JE (1997). Eating disorders and comorbidity: empirical, conceptual, and clinical implications. Psychopharmacology Bulletin 33, 381–390.Google ScholarPubMed