Detection of bulimia nervosa in primary health care consultations

Abstract

Introduction. To estimate the prevalence of bulimia n e rvosa and bulimic behavior in women who come to Primary Health Care consultations, using the DSM-IV criteria .

Design. Descriptive, observational study

Setting. Primary Health Care.

Participants. Women over 14 years who come to general medicine consultations. Selection by systematic sampling of 175 women (proportion expected: 4%; confidence index: 95%; accuracy: ±3%).

Main measures. Examination, by semi-structured interview, of diagnostic criteria of bulimia (recurrent binge eating, compensatory behaviors and excessive concern about weight or body image), socio-demographic variables and variables on morbidity (health problems according to CIPSAP-2-defined).

Results. Prevalence of bulimia was 5.3% (95% CI: 2.4-9.7), there being recurrent binge-eating in 23.4%. Among the compensatory behaviors, fasting (13.5%), intense exercise (8.2%) and self-induced vomiting (4.7%) were the most frequent. In women with bulimia, a background of anorexia and establishment of goals to lose weight appeared more frequently (p< 0.05). Their average age was significantly lower (p<0.05) (31.2±14.7 SD). By logistic regression, the associated variables with the presence of bulimia were age (OR: 0.94), existence of previous psychiatric morbidity (OR: 9.0) and having previously set goals to lose weight (OR:7.3).

Conclusions. In the women who came to the Primary Health Care consultations, prevalence of bulimia is greater than that described in the general female population. This disorder is more frequent in younger women and in those who present a background of psychiatric morbidity. Examination of the diagnostic criteria makes its detection easy in Primary Health Care consultations.