Beyond screening in primary practice settings: Time to stop fiddling while Rome is burning

Area of Science:

• Psychiatry
• Public Health
• Healthcare Policy

Background:

• Screening for eating disorders in primary care is essential for early intervention.
• Progress in developing effective screening instruments and their integration into practice has been slow.

Purpose of the Study:

• To review the current state of research on eating disorder screening in community and primary care settings.
• To critique existing screening instruments and identify barriers to case detection and referral.

Main Methods:

• Historical overview of eating disorder screening instruments.
• Critique of contemporary instruments, practices, and referral pathways.
• Analysis of barriers to case detection and treatment access.

Main Results:

• Numerous screening instruments exist, but many lack high positive predictive power, though some demonstrate high sensitivity.
• Barriers to detection include insufficient education for primary care professionals and patient reluctance to discuss concerns.
• Even the best screening tools cannot overcome these systemic barriers.

Conclusions:

• There is an urgent need to enhance existing, highly sensitive screening instruments for eating disorders.
• Improving primary care professionals' skills in assessment and management is critical.
• Empowering individuals with eating disorders to navigate care pathways is essential for increasing treatment access.