Robbie Campbell MD FRCPC, Jill Mustin-Powell RN, Megan Johnston PhD, Miky Kaushal MD, Larry Stitt MSc, Amresh Srivastava MRCPsych FRCPC Purpose: Comorbidity of eating disorders and its behavioral traits are common amongst psychiatric patients. Eating disorders are often missed or misdiagnosed which leads to poorer clinical outcome and low functioning, though it is a treatable condition. Patients with eating disorders also tend to have severe psychopathology, which increases risk of suicide, duration of hospitalization and polypharmacy. The present study examines the presence of comorbid eating disorders and their behavioral symptoms in hospitalized adult psychiatric patients. Methods: The study was carried out at the RMHC London. This is an open level cohort study in a naturalistic clinical setting. We randomly selected 91 patients between ages of 25 to 60 years and assessed for screening of eating disorders using the Eating Attitudes Test (EAT-26) scale. Psychopathology and suicidality was assessed using the Brief Psychiatric Rating Scale (BPRS) for psychosis, Hamilton Depression Rating Scale (HDRS) for depression and Scale for Impact of Suicidality-Management, Assessment and Planning of Care (SISMAP) for suicidality and resilience (CD-RISK). Data was analyzed by SPSS. Results: A total of 16.5 % (15/91) showed presence of an eating disorder (EAT-26 score >20). For the 91 with EAT-26 scores, there were 44 males and 47 females. 15 patients (16.5%), male 1 and females 14) showed EAT score >20, considered positive for possibility of eating disorder and 60% of these patients were actually having a DSM-IV diagnosis of eating disorder. Significantly more females showed possibility of eating disorders on screening compared to males [29.8%, 14/47 female vs. 3%, 1/44 males (p<. 001)] and no difference was observed in mean age of those with and those without an eating disorder (Mean age of 42.1 in those with EAT score <=20 compared to 37.8 in those with EAT score >20, p<.271). Patients with the possibility of a diagnosis of an eating disorder (EAT >20) showed significantly higher suicidality than those without it as measured by SIS-MAP brief scanner score (11.1 vs. 8.4, p= 013). Conclusions: Our study shows that behavioral traits of eating disorders can be identified. 16.5% hospitalized patients, predominantly females 29.8%, showed possibility of a diagnosis of an eating disorder. These patients were having significantly higher suicidality scores. Expected Outcomes: Identification of eating disorders is a matter of patient safety and should be employed in routine clinical practice. The policy for patient safety and risk management needs to pay attention to the detection of patients who are at-risk of have a diagnosis of an eating disorder.
Available at: http://works.bepress.com/amreshsrivastava/140/