Changing patterns of referral to an eating disorders clinic.

A decline in overall referrals was noted at the eating disorders clinic, Manawaroa centre for psychological medicine in 1987. At the same time a proportional increase in referrals for bulimia was observed. To gather more information on these apparent changes, data on the clinic's referral pattern were collected and general practitioners in the area health board district were surveyed. The results suggested a relatively stable referral rate from 1983-9, with an average of 31 referrals per year. However, there appears to have been a decrease in anorexia nervosa, from over 50% of referrals in 1983 to approximately 5% of referrals in 1988-9, and a corresponding rise in bulimia from 8% in 1983 to 49% in 1988 and 35% in 1989. Responses were received from 61 general practitioners, 78% of those surveyed. Most general practitioners indicated that they perceived a need for an eating disorders clinic, but only 40% had referred to the clinic. The main reasons given for not referring were: no appropriate patients (33%), the general practitioner was unaware of the clinic (29%), and the patient was being maintained by the general practitioner (25%).