Secret patterns: Validation of a screening tool to detect bulimia

We prospectively validated a two-item screening tool for bulimia. Subjects recruited from a women's health practice completed the previously developed two-item screening tool ("Do you ever eat in secret?" and "Are you satisfied with your eating patterns?") at their initial office visit. This was validated against a telephone interview with a licensed psychologist. The prevalence of current bulimia was 16% in 75 subjects, determined by psychologists' assessment (sensitivity 75%, specificity 49%) and 4% by DSM-III-R criteria. The positive and negative predictive values of one screening question positive were 22% and 91%, respectively, when compared with the psychologists' assessments as the gold standard. This screening tool allows physicians to identify patients who warrant further valuation for bulimia.