Differential diagnoses to consider at an eating disorders clinic

To determine the reasons for referral of patients without eating disorders who were within a cohort of patients referred to an adult tertiary care eating disorders program.

Cases were obtained by retrospectively reviewing all the charts of patients who had been referred to a single eating disorders program over a 20-year period from 1981 to 2000. All referred cases had been screened by a nurse using a telephone or written questionnaire.

Thirty-three out of 987 patients (3.3%) were identified as having no eating disorders. Four subjects were males (12.1%) and 29 were females (87.9%). After investigation, 16 were found to have a psychiatric diagnosis, 8 had a medical diagnosis, and 8 had no identifiable diagnosis.

This study shows that the screening process for referral to a tertiary care eating disorders program is highly reliable and suspicion for a patient without an eating disorder should be low; in comparison with the eating disorder population, these patients are more likely to be male and psychiatric illnesses are twice more likely than medical disorders to be diagnosed.