Reliability And Validity Of The Chinese Version Of The Eating Disorder Examination Questionnaire 6.0 And Its Application In Clinical Practice

Background:Eating disorders(EDs)are characterized by persistent eating-related behavior that results in the altered consumption or absorption of food,and that significantly impairs physical health or psychosocial functioning1.EDs mainly include anorexia nervosa(AN)and bulimia nervosa(BN)in different diagnosis systems.Research suggests that EDs are increasingly prevalent in China,with several surveys reporting surprisingly high levels of weight concerns among female adolescents.Eating disorders have become a serious challenge for the development of physical and mental health of young people in China today.It is urgent to study the diagnosis and treatment of the disease.Objective:Eating disorders have some very special behaviors and cognitions,so it is suitable to use scales for screening and additional diagnosis.EDE-Q is one of the most widely used self-assessment questionnaire for assessing the psychological and pathological characteristics of eating disorders in the current international.The initial objective preparation was to assess the eating disorders,but now is increasingly used in clinical and research purpose in the western and non western countries,and has showed good psychometric properties as a preliminary screening tool and symptom severity assessment tool.Compared with other self-assesment questionnaires,EDE-Q includes not only the core psychological symptoms of eating disorders and related eating attitudes and behavior,but also including the frequency of eating disorder behaviors,EDE-Q can not only be used to measure the severity ofeating disorder symptoms,and can be used as a preliminary screening tool,but also assisted the corresponding DSM-IV diagnosis.So it is necessary to introduce EDE-Q to make up the deficiency in this field.Methods:The objective is to evaluate the reliability and validity of the Chinese version of the Eating Disorder Examination Questionnaire 6.0(EDE-Q 6.0)in patients with eating disorders.,and then discussing the diagnosis value of the Chinese version,finally comparing EDE-Q with the eating attitudes questionnaire EAT-26 and the Eating Disorder Inventory EDI-1.Study subjects were divided into two groups,one group is 248 cases of outpatients and inpatients with eating disorders from the Shanghai Mental Health Center;another one is a total of 296 healthy controls which were randomly selected from the staff of the center,a university and a middle school students in shanghai.Among all participants,98 patients and30 healthy controls were retested with a month interval.All the statistics are dealed with by the related procedure in SPSS20.0 and LISREL8.7.Results:The Cronbach ? coefficients for the EDE-Q6.0 total scores were 0.95,0.86,0.74,0.91 and 0.87 for the 4 factors.The test-retest reliabilities(ICC)were 0.79 for the total scale,0.69,0.76,0.78 and 0.78 for the 4 factors.The EDE-Q 6.0 total score and the EDI-1 total score had a high consistency in the total sample,patients and controls,respectively(r=0.77,0.68,0.42).Patients had higher scores on the EDE-Q 6.0 than controls(Ps< 0.01).The mean area under the curve(AUC)of EDE-Q6.0was 0.91,the optimal cut-off point of EDE-Q6.0 was total score?1.27,sensitivity and specificity were 79.4% and 88.2% respectively.The AUC of EAT-26 and EDI-1 were 0.83(sensitivity=66.3%,specificity=86.1%)and 0.87(sensitivity=78.2%,specificity=84.0%),respectively.Conclusions :(1)Chinese version of eating disorder examination questionnaire EDE-Q6.0 has good reliability and validity,it can be used to assess the Chinese eating disorder patients and high risk population's eating disorder symptoms,the total score of EDE-Q can be used as a indicator of the severity of symptoms.Compared with otherself-assessment questionnaires,EDE-Q is more suitable for the initial screening and epidemiological investigation of eating disorders or suspicious people in the population.(2)This study is a preliminary attempt by introducing EDE-Q6.0,so it's need a wider range,more samples of different groups to revise the scale in the future,further evaluation is necessary,especially in the follow-up study,it is necessary to explore the factor structure of the EDE-Q,and then develop a suitable theoretical structure for Chinese population.In addition,due to the limited number of samples in this study,we hope to go on further study with larger sample size in the near future to establish the Eating Disorder Examination Questionnaire norm,and further determine the cut-off point,to test its applicability and expand its application value.