Assessment of eating disorders with the diabetes eating problems survey – revised (DEPS-R) in a representative sample of insulin-treated diabetic patients: a validation study in Italy

Federica Pinna, Enrica Diana, Lucia Sanna, Valeria Deiana, Mirko Manchia, Eraldo Nicotra, Andrea Fiorillo, Umberto Albert, Alessandra Nivoli, Umberto Volpe, Anna Rita Atti, Silvia Ferrari, Federica Medda, Maria Gloria Atzeni, Daniela Manca, Elisa Mascia, Fernando Farci, Mariangela Ghiani, Rossella Cau, Marta Tuveri, Efisio Cossu, Elena Loy, Alessandra Mereu, Stefano Mariotti, Bernardo Carpiniello

The purpose of the study was to evaluate in a sample of insulin-treated diabetic patients, with type 1 or type 2 diabetes, the psychometric characteristics of the Italian version of the DEPS-R scale, a diabetes-specific self-report questionnaire used to analyze disordered eating behaviors. The study was performed on 211 consecutive insulin-treated diabetic patients attending two specialist centers. Lifetime prevalence of eating disorders (EDs) according to DSM-IV and DSM-5 criteria were assessed by means of the Module H of the Structured Clinical Interview for DSM IV Axis I Disorder and the Module H modified, according to DSM-5 criteria. The following questionnaires were administered: DEPS-R and the Eating Disorder Inventory - 3 (EDI-3). Test/retest reproducibility was assessed on a subgroup of 70 patients. The factorial structure, internal consistency, test-retest reliability and concurrent validity of DEPS-R were assessed. Overall, 21.8% of the sample met criteria for at least one DSM-5 diagnosis of ED. A "clinical risk" of ED was observed in 13.3% of the sample. Females displayed higher scores at DEPS-R, a higher percentage of at least one diagnosis of ED and a higher clinical risk for ED. A high level of reproducibility and homogeneity of the scale were revealed. A significant correlation was detected between DEPS-R and the 3 ED risk scales of EDI-3. The data confirmed the overall reliability and validity of the scale. In view of the significance and implications of EDs in diabetic patients, it should be conducted a more extensive investigation of the phenomenon by means of evaluation instruments of demonstrated validity and reliability.