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Comparison of Single- and Double-Stage Designs in the Prevalence Estimation of Eating Disorders in Community Samples
Published online by Cambridge University Press: 10 April 2014
Abstract
The aim of this research was to compare two different case-identification designs: (a) a one-stage anonymous design using the Eating Disorders Examination-Questionnaire (EDE-Q; Fairburn & Beglin, 1994) as diagnostic instrument and (b) a two-stage-non-anonymous design using the Eating Attitudes Test (EAT; Garner & Garfinkel, 1979) and the EDE-Q as screening instruments and the clinical interview Eating Disorders Examination (EDE; Fairburn & Cooper, 1993) as diagnostic instrument, in the estimation of eating disorders prevalence in community samples. Both epidemiological designs were compared in: eating disorders prevalence, population at risk, and weekly frequency of associated symptomatology (binge eating episodes, self-vomiting) within a sample of 559 scholars (14 to 18 year-old males and females) studying in the region of Madrid. Eating disorders prevalence estimation using single-stage design was 6.2%, and 3% using the two-stage design; however, these differences were not significant (p = .067). No significant differences between the two procedures were found either in population at risk or in weekly frequency of reported self-vomiting. Reported binge eating episodes were higher in the one-stage design. The use of a two-stage procedure with clinical interview (vs. questionnaire) leads to a better understanding of the items (specially the most ambiguous ones) and thus, to a more accurate prevalence estimation.
El objetivo era comparar la adecuación de dos protocolos en la estimación de prevalencia de trastornos de la conducta alimentaria (TCA): Protocolo de una fase, anónimo, usando como instrumento diagnóstico “Eating Disorders Examination-Questionnaire” (EDE-Q; Fairburn & Beglin, 1994); y Protocolo de doble fase, no anónimo, usando como instrumentos de “cribado” el “Eating Attitudes Test” (EAT; Garner & Garfinkel, 1979) y el EDE-Q; y como instrumento diagnóstico el “Eating Disorders Examination” (EDE; Fairburn & Cooper, 1993). Ambos protocolos fueron comparados en estimación de prevalencia de TCA, población en riesgo y frecuencia semanal de sintomatología asociada (episodios de sobreingesta y vómitos autoinducidos), en 559 adolescentes (ambos sexos) 14 - 18 años escolarizados en la Comunidad de Madrid. La estimación de prevalencia TCA con el protocolo de una fase fue 6,2%; y con el protocolo de dos fases, 3%, aunque las diferencias no fueron significativas (p = 0,067). No hubo diferencias significativas en cuanto a población en riesgo ni en frecuencia semanal de vómitos autoinducidos obtenida por ambos protocolos. La frecuencia semanal de atracones fue superior en el grupo de una fase. El protocolo de dos fases permite una mejor comprensión de los ítems y, por tanto, es más aconsejable para una estimación más precisa de la prevalencia de TCA.
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