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. 2023 May 31;23(1):382.
doi: 10.1186/s12888-023-04744-6.

Validation of the traditional Chinese version of the diabetes eating problem survey-revised and study of the prevalence of disordered eating patterns in Chinese patients with type 1 DM

Chi Wing Lok  1 , Mei Cheung Wong  2 , Kim Wai Yip  2 , Wing Ka Ching  2 , Edward Kwok Yiu Choi  3
Affiliations

Validation of the traditional Chinese version of the diabetes eating problem survey-revised and study of the prevalence of disordered eating patterns in Chinese patients with type 1 DM

Chi Wing Lok et al. BMC Psychiatry. .

Abstract

Background: Disordered eating behaviours (DEBs) in patients with type 1 diabetes mellitus (T1DM) are associated with an increased risk of complications and mortality. The Diabetes Eating Problem Survey-Revised (DEPS-R) was developed to screen for DEBs in T1DM patients. The objectives of this study were to develop a traditional Chinese version DEPS-R (electronic version) and to measure the prevalence of DEBs in a local population sample.

Methods: The DEPS-R was translated into traditional Chinese, modified and developed into an electronic version. The psychometric properties of the C-DEPS-R were tested on T1DM patients from 15 to 64 years old. The factor structure of the traditional C-DEPS-R was examined by confirmatory factor analysis (CFA). The C-EDE-Q and the C-DES-20 were used for convergent and divergent validity testing, respectively. Module H of the CB-SCID-I/P was used as a diagnostic tool for eating disorders. A correlation study was conducted with the C-DEPS-R scores obtained and the clinical characteristics. Type 2 diabetic (T2DM) patients on insulin treatment were recruited as controls.

Results: In total, 228 T1DM patients and 58 T2DM patients were recruited. There was good internal consistency of the traditional C-DEPS-R (electronic version), with the McDonald's omega of 0.825 and test-retest reliability of 0.991. A three-factor model of the traditional C-DEPS-R was confirmed by CFA. The cut-off score for the traditional C-DEPS-R was determined to be 24; 13.2% (95% CI 8.8%-17.5%) of T1DM patients were found to score above the cut-off score, while 7.5% (95% CI 4-10.9%) scored above the cut-off by the C-EDE-Q, and 4.4% (95% CI 2.1%-7.9%) were diagnosed with eating disorders by the CB-SCID-I/P Module H. Females with T1DM scored higher on the traditional C-DEPS-R. There was a significant correlation of the C-DEPS-R with BMI, occurrence of DKA, use of a continuous glucose monitoring system and positive diagnosis by the CB-SCID-I/P module H (p < 0.05).

Conclusion: The traditional Chinese-DEPS-R (electronic version) demonstrated good psychometric properties. It is a self-rated, time-efficient and reliable tool for the screening of disordered eating behaviours in T1DM patients in the Chinese population of Hong Kong. Disordered eating behaviours, such as insulin omission, are associated with an increased risk of diabetes mellitus-related complications and mortality. Generic screening tools for eating disorders may over- or underestimate such problems in diabetic patients. Type 1 diabetes mellitus patients are at particular risk of developing disordered eating behaviours or eating disorders, yet studies in Chinese populations are limited. This study developed and validated the traditional Chinese (electronic) version of the Diabetes Eating Problem Survey-Revised (DEPS-R). The traditional Chinese-DEPS-R is a self-rated, time-efficient and reliable tool for the screening of disordered eating behaviours in Type 1 diabetes mellitus patients in the Chinese population of Hong Kong. The study also estimated the prevalence of disordered eating behaviours in diabetic patients from the local Chinese population, and the clinical correlations of the symptoms and clinical parameters were explored. The study reflected a higher prevalence of eating problems in the Type 1 diabetes mellitus population and demonstrated significant correlations of eating problems with BMI as well as the occurrence of diabetic ketoacidosis. Correspondence: lcw891@ha.org.hk.

Keywords: DEPS-R; Diabetes eating Problem Survey-Revised; Disordered eating behaviours; Disordered eating patterns; T1DM; Type 1 diabetes mellitus.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Development of traditional C-DEPS-R Note: DEPS-R: Diabetes Eating Problem Survey-Revised. C-DEPS-R: Traditional Chinese Diabetes Eating Problem Survey-Revised. C-DEPS-R Vr. 1: C-DEPS-R version 1. C-DEPS-R Vr. 2: C-DEPS-R version 2. C-DEPS-R Vr. 3: C-DEPS-R version 3.
Fig. 2
Fig. 2
Recruitment flow
Fig. 3
Fig. 3
3-factor model of CFA (T1DM participants, N = 228) Note: Rectangles represent observed variables (items in the C-DEPS-R) Ellipses represent latent variables Double-headed arrows are symbols for a correlation The values between the observed and latent variables represent standardised factor loadings The values next to the arrows between the latent variables are standardised regression weights
See this image and copyright information in PMC

References

    1. Mehler PS, Brown C. Anorexia nervosa – medical complications.Journal of Eating Disorders. 2015;3(1). - PMC - PubMed
    1. Mitchell JE, Crow S. Medical complications of anorexia nervosa and bulimia nervosa. Curr Opin Psychiatry. 2006;19(4):438–43. - PubMed
    1. Blinder BJ, Cumella EJ, Sanathara VA. Psychiatric comorbidities of female inpatients with eating disorders. Psychosom Med. 2006;68(3):454–62. - PubMed
    1. Goebel-Fabbri AE. Disturbed eating behaviors and eating disorders in type 1 diabetes: clinical significance and treatment recommendations. Curr Diab Rep. 2009;9(2):133–9. - PubMed
    1. Pereira RF, Alvarenga M. Disordered eating: identifying, treating, preventing, and differentiating it from eating disorders. Diabetes Spectr. 2007;20(3):141–8.

MeSH terms