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Essstörungen in der hausärztlichen Versorgung — eine Literaturübersicht

Eating disorder in general practice: A literature review

  • Psychotherapie und Psychosomatik
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Zusammenfassung

In einer Literaturübersicht werden folgende Fragen beantwortet: Wie häufig sind Essstörungen? Gibt es präventive Maßnahmen? Wie häufig und zu welchem Zeitpunkt sieht der Hausarzt Esssstörungen? Wie präsentieren sich essgestörte Patientinnen und Patienten in der Praxis? Bei ansteigender Inzidenz von Esssstörungen, insbesondere von Bulimia nervosa, wird die Diagnostik und Therapie durch das doppeldeutige Verhalten der Patientinnen und Patienten und die Präsentation vorgeschobener Symptome erschwert. Es gibt noch keine validierten, praxisgerechten Schulungen in Zusammenarbeit mit allgemeinärztlichen Praxen. Viele Allgemeinärzte zeigen ein Verhalten, das von Frustration, wenig ausgeprägter Empathie und Hilflosigkeit geprägt ist.

Summary

In this literature review, answer were given to the following questions: How often do eating disorders occur? Are there any preventive interventions? How often and at which moment does the family doctor recognise eating disorders? How do patients with eating disorders present themselves in general practice? Increased incidences of eating disorders, especially bulimia nervosa, and difficulties in diagnostic and therapy as well as the ambiguous behaviour of patients in the presentation of delayed symptoms let diagnose only a small part of these patients. There is no valid practice oriented training for general practice. Many general practitioners show a behaviour that is characterised by frustration and helplessness, less marked by empathy.

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Literatur

  1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-IV). 4th Edition. Washington: American Psychiatric Association, 1994

    Google Scholar 

  2. Anstine D, Grinenko D: Rapid screening for disordered eating in college-aged females in the primary care setting. J Adolesc Health 2000; 26: 338–42

    Article  CAS  PubMed  Google Scholar 

  3. Batal H, Johnson M, Lehmann D, Steele A, Mehler PS: Bulimia: a primary care approach. J Adolesc Health 1999; 24: 324–327

    Google Scholar 

  4. Britt E, Del Gobbp S: Changing patterns of referral to an eating disorders clinic. New Zealand Medical Journal 1990; 103: 564–5

    CAS  PubMed  Google Scholar 

  5. Buddeberg-Fischer B: Disorders of eating behaviour – early detection and treatment possibilities in general practice. Schweiz Rundsch Med Prax 1997; 86: 1209–12

    CAS  Google Scholar 

  6. Buddeberg-Fischer B, Klaghofer R, Gnam G, Buddeberg C: Prevention of disturbed eating behaviour: A prospective intervention study in 14–19-year-old Swiss students. Acta Psychiatrica Scandinavia 1998; 98: 146–155

    Article  CAS  Google Scholar 

  7. Burket RC, Schramm LL: Therapist´s attitudes about treating patients with eating disorders. South Med J 1995; 88: 813–8

    Article  CAS  PubMed  Google Scholar 

  8. Bursten MS, Gabel LL, Brose JA, Monk JS: Detecting and treating bulimia nervosa: how involved are family physicians? J Am Board Fam Pract 1996; 4: 241–8

    Google Scholar 

  9. Carter JC, Fairburn CG: Treating binge eating problems in primary care. Addict Behav 1995; 20: 765–72

    Article  CAS  PubMed  Google Scholar 

  10. Chitty KK: The primary prevention role of the nurse in eating disorders

  11. Cochrane Review: Interventions for prevention of eating disorders in children and adults. Cochrane Rev 2002; 20: 204–246

    Google Scholar 

  12. Danci LA, Coffey CMM, Veit FCM, Carr-Gregg M, Patton GC, Day N, Bowes G: Evaluation of the effectiveness of an educational intervention for general practicioners in adolescent health care: randomised controlled trial. BMJ 2000; 320: 224–230

    Article  Google Scholar 

  13. Freund KM, Boss RD, Handleman EK, Smith AD: Secret patterns: validation of a screening tool to detect bulimia. J Womens Health Gen Based Med 1999; 8: 1281–4

    Article  CAS  Google Scholar 

  14. Freund KM, Graham SM, Lesky LG, Moskowitz MA: Detection of bulimia in a primary care setting. J Gen Intern Med 1993; 8: 236–42

    Article  CAS  PubMed  Google Scholar 

  15. Garner DM, Garfinkel PE: Socio-cultural factors in the development of anorexia nervosa. Psychol Med 1980; 10: 647

    Article  CAS  PubMed  Google Scholar 

  16. Guerro-Prado D, Barjau R, Chinchilla MA: The epidemiology of eating disorders and the influence of mass media: a literature review. Actas Esp Psiquiatr 2001; 29: 403–10

    CAS  PubMed  Google Scholar 

  17. Hoek HW: The incidence and prevalence of anorexia nervosa and bulimia nervosa in primary care. Psychological medicine 1991; 21: 455–460

    Article  CAS  PubMed  Google Scholar 

  18. Johnson JG, Spitzer RL, Williams JB: Health problems, impairment and illnesses associated with bulimia nervosa and binge eating disorder among primary care and obstetric gynaecology patients. Psychol Med 2001; 31: 1455–66

    Article  CAS  PubMed  Google Scholar 

  19. Jerome LW: Primary intervention for bulimia: The evaluation of a media presentation for an adolescent population. Dissertation Abstracts International: The Sciences and Engineering 1991; 52: 3296

    Google Scholar 

  20. Killen JD: Development and evaluation of a school-based eating disorder symptoms prevention program. In: Levine MP et al. editor(s). The developmental psychopathology of eating disorders: Implication for research, prevention and treatment. Mahwah NJ: Lawrence Erlbaum & Associates 1996

    Google Scholar 

  21. Killen JD, Taylor CB, Hammer LD, Litt I et al.: An attempt to modify unhealthful eating attitudes and weight regulation practices of young adolescent girls. Int J of Eating Disorders 1993; 13: 369–384

    Article  CAS  Google Scholar 

  22. King MB: Eating disorders in a general practice population. Prevalence, characteristics and follow-up at 12 to 18 months. Psychological Medicine 1989; Suppl. 14: 324–326

    Google Scholar 

  23. King MB: Eating disorders in general practice. BMJ 1986; 293: 1412–1414

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Kusel AB: Primary prevention of eating disorders through media literacy training of girls. Dissertation Abstracts International B: The Sciences & Engineering, 1999; 60: 1859

    Google Scholar 

  25. Lipscomb PA: Bulimia: diagnosis and management in the primary care setting. J Fam Pract 1987; 24: 187–194

    CAS  PubMed  Google Scholar 

  26. Maradiegue A, Cecelic E, Bozzelli MJ, Frances G: Do primary care providers screen for eating disorders? Gastroenterology Nursing 1996; 19: 65–69

    Article  CAS  PubMed  Google Scholar 

  27. Mattingly D, Bhanji S: The diagnosis of anorexia nervosa. Journal of the Royal College of Physicians of London 1982; 16: 191–4

    CAS  PubMed  PubMed Central  Google Scholar 

  28. Meadows GN, Palmer RL, Newball EU, Kenrick JM: eating attitudes and disorder in young women: a general practice based survey. Psychol Med 1997; 13: 175–181

    Google Scholar 

  29. Meadows GN, Palmer RL, Newball EUM, Kendrick JMT: Eating attitudes and disorder in young women: a general practice based survey. Psychol Med 1996; 16: 191–194

    Google Scholar 

  30. Muscari ME: The role of the nurse practicioner in the diagnosis and mangement of bulimia nervosa. Journal of the American Academy of Nurse Practicioners 1993; 5: 259–263

    Article  CAS  Google Scholar 

  31. Muscari ME: Primary health care of adolescents with bulimia nervosa. J Pediatr Health Care 1996; 10: 17–25

    Article  CAS  PubMed  Google Scholar 

  32. Nielsen S: Epidemiology and mortality of eating disorders. Psychiatr Clin North Am 2001; 24: 201–14

    Article  CAS  PubMed  Google Scholar 

  33. Neumark-Sztainer D, Sherwood N, Coller T, Hannan P: Primary prevention of disordered eating among preadolescent girls: Feasibility and short-term effect of a community-based intervention. Journal of the American Dietetic Association 2000; 100: 1466–1473

    Article  CAS  PubMed  Google Scholar 

  34. O’Dea JA, Abraham S: Improving the body image, eating attitudes and behaviors of young male and female adolescents: A new educational approach which focuses on self-esteem. Int J of Eating Disorders 2000; 28: 43–57

    Article  Google Scholar 

  35. Ogg E, Millar HR, Pusztai EE, Thom AS: General practice consultation patterns preceding diagnosis of Eating Disorders.

  36. Paur I: Eating Disorders in General Practice. Posterpräsentation DEGAM-Kongress 9.2002 in Koblenz

  37. Powers PS: Initial assessment and early treatment options for anorexia nervosa and bulimia nervosa. Psychiatr Clin North Am 1996; 19: 639–55

    Article  CAS  PubMed  Google Scholar 

  38. Powers PS, Santana CA: Eating disorders: a guide for the primary care physician. Prim Care 2002; 29: 81–89

    Article  PubMed  Google Scholar 

  39. Pratt BM, Woolfenden SR: Interventions for preventing eating disorders in children and adolescents (Cochrane Review), in: The Cochrane Library, Issue 2, 2002

  40. Putukian M: The female triad – eating disorders, amenorrhea, and osteoporosis. Sports Medicine 1994; 78: 345–356

    CAS  Google Scholar 

  41. Robinson WD, Prest LA, Susman JL, Rouse J, Crabtree B: Technician, Friend, Detective, and Healer: Family Physician`s Responses to Emotional Distress. The Journal of Family Practice 2001; 50: 864–869

    CAS  PubMed  Google Scholar 

  42. Rohde J, Johannes A, Labeck L, Kelly JT: Diagnos and treatment of anorexia nervosa. J Fam Pract 1980; 10: 1007–12

    CAS  PubMed  Google Scholar 

  43. Santonastaso P, Zanetti T, Ferrara S, Olivotto MC, Magnavita N, Favaro A: A preventive intervention program in adolescent school-girls: A longitudinal study. Psychotherapy and Psychosomatics 1999; 68: 46–50

    Article  CAS  PubMed  Google Scholar 

  44. Slaughter JR, Sun AM: In pursuit of perfection: a primary care physician´s guide to body dysmorphic disorder

  45. Treasure J, Schmidt U, Troop N, Tiller J, Todd G, Keilen M, Dodge E: First step in managing bulimia nervosa: controlled trial of therapeutic manual. BMJ 1994; 308: 686–9

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. Treasure J, Ward A et al.: A randomised controlled trial of sequential treatment for bulimia nervosa incorporating a self-care-manual: Outcome at end of treatment and at eighteen month folllow-up. British Journal of Psychiatry 1996; 168: 94–98

    Article  CAS  Google Scholar 

  47. Treasure J, Ward A: A practical guide to the use of motivational interviewing in anorexia nervosa. European eating Disorders Review 1996; 97: 71–76

    Google Scholar 

  48. Tsai G: Eating disorders in the Far East. Eat Weight Disord 2000, 5: 183–97

    Article  CAS  PubMed  Google Scholar 

  49. Turnbull S, Ward A, Treasure J, Jick H, Derby L: The demand for eating disorder care: an epidemiological study using the General Practice Research Database. British Journal of Psychiatry 1996; 169: 705–12

    Article  CAS  Google Scholar 

  50. Vandereycken W, van Deth R, Meermann R: Hungerkünstler, Fastenwunder, Magersucht. Eine Kulturgeschichte der Eßstörungen. 1990, Biermann-Verlag

  51. Waller D, Fairburn CG, McPherson A, Kay R, Lee A, Nowell T: Treating bulimia nervosa in primary care: a pilot study. Int J of Eating Disorders 1996; 19: 99–103

    Article  CAS  Google Scholar 

  52. Walsh JM, Wheat ME, Freund K: Detection, evaluation, and treatment of eating disorders: the role of the primary care physician. J Gen Intern Med 2000; 15: 577–90

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  53. Wells S, Wells E, Mc Kenzie JM, Hornblow AR: Eating and weight problems among women attending their general practicioner. New Zealand Medical Journal 1986: 671–673

  54. Whitehouse AM, Cooper PJ, Vize CV, Hill C, Vogel L: Prevalence of eating disorders in three Cambridge general practices: hidden and conspicuous morbidity. British Journal of General Practice 1992; 42: 57–60

    CAS  Google Scholar 

  55. Wildes JE, Emery RE, Simons AD: The roles of ethnicity and culture in the development of eating disturbance and body dissatisfaction: a meta-analytic review. Clin Psych Rev 2001; 21: 521–51

    Article  CAS  Google Scholar 

  56. Wilfley DE, Grilo CM: Eating disorders: a women´s health problem in primary care. Nurse Pract Forum 1994; 5: 34–45

    CAS  PubMed  Google Scholar 

  57. Williams P, King M: The »epidemic« of anorexia nervosa: another medical myth? The Lancet 1987; I: 205–207

    Article  Google Scholar 

  58. Yanovski SZ: Bulimia nervosa: the role of the family physician. Am Fam Physician 1991; 44: 1231–8

    CAS  PubMed  Google Scholar 

  59. Zanetti T, Ferrara S, Favaro A, Santonastaso P: Teaching teachers prevention interventions. In: European Council of Eating Disorders, Stockholm. 15–17 September; 1999: 19 (abstract)

  60. Zinkand H, Cadoret R, Widmer RB: Incidence and detection of bulimia in a family practice population

  61. Zipfel S, Löwe B, Reas DL, Deter H-C, Herzog W: Long-term prognosis in anorexia nervosa: lessons from a 21-year follow-up study

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Paur, I. Essstörungen in der hausärztlichen Versorgung — eine Literaturübersicht. Z Allg Med 79, 228–233 (2003). https://doi.org/10.1007/BF03653229

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