International consensus on patient-centred outcomes in eating disorders

Abstract

The effectiveness of mental health care can be improved through coordinated and wide-scale outcome measurement. The International Consortium for Health Outcomes Measurement (ICHOM) has produced collaborative sets of outcome measures for various mental health conditions, but no universal guideline yet exists for eating disorders (EDs). This position paper presents a set of outcomes and measures for EDs as determined by 24 international experts from professional and lived experience backgrounds. An adapted Delphi technique was used, and provisional results were validated through an open review survey (n=207). Final recommendations suggest tracking outcomes across four domains: ED behaviours/cognitions, physical health, co-occurring mental health conditions and quality of life/social functioning. These outcomes are captured across three to five patient reported measures per individual. For children, the measures include the Children’s Eating Attitude Test (or for those with ARFID, the Eating Disorder in Youth Questionnaire), the KIDSCREEN-10, and the Revised Children’s Anxiety and Depression Screener-25. For adults, this includes the Eating Disorder Examination Questionnaire (or for ARFID, the Nine-item ARFID Screener), the Patient Health Questionnaire-2/9, the Generalised Anxiety Disorder-2/7, the Clinical Impairment Assessment, and the World Health Organization Disability Assessment Schedule 2.0-12. These questionnaires should be supplemented by information on patient characteristics and circumstances that may impact outcomes (i.e., demographic, historical, and clinical factors, including comorbidities). Adoption of these guidelines on a wide scale will allow comparison of research and clinical intervention so the field can better determine which settings and interventions work best and for whom.