The SCOFF questionnaire: assessment of a new screening tool for eating disorders

TLDR

Eating disorders are common psychiatric disorders in young women, early detection improves prognosis, yet presentation is often cryptic, existing questionnaires are lengthy and specialist‑dependent, and no simple, memorable screening tool is available for non‑specialists, unlike the CAGE questionnaire for alcohol misuse. The authors aimed to develop and test a concise screening tool for eating disorders that flags possible cases before formal clinical assessment. They created five questions targeting core features of anorexia nervosa and bulimia nervosa through focus groups of patients and specialists, and evaluated the tool in a feasibility study with patients and staff at an eating disorders unit.

Abstract

Eating disorders are among the most common psychiatric disorders in young women. Early detection and treatment improves prognosis, but presentation is often cryptic—for example, via physical symptoms in primary care. Ability to diagnose the condition varies and can be inadequate,1 and existing questionnaires for detection 2 3 are lengthy and may require specialist interpretation. No simple, memorable screening instruments are available for non-specialists. In alcohol misuse the CAGE questionnaire4 has proved popular with clinicians because of its simplicity. We developed and tested a similar tool for eating disorders— with questions designed to raise suspicion that an eating disorder might exist—before rigorous clinical assessment. We developed five questions addressing core features of anorexia nervosa and bulimia nervosa using focus groups of patients with eating disorders and specialists in eating disorders; we tested the questions in a feasibility study of patients and staff at an eating disorders unit None …