Dépistage de l’hyperphagie boulimique chez les adolescents : validité faciale d’un questionnaire développé en français

RésuméL’hyperphagie boulimique est un trouble du comportement alimentaire fréquemment associé à l’obésité et compliquant sa prise en charge. Des études ont montré que des crises de boulimie pouvaient être observées chez les enfants et adolescents, sans que tous les critères nécessaires au diagnostic d’hyperphagie boulimique soient remplis. Or dans cette population, même lorsque le trouble se présente de manière partielle, des complications peuvent être observées. C’est pourquoi des critères provisoires ont été proposés pour cette population plus jeune. Il est maintenant urgent d’avoir à disposition des outils permettant le dépistage et l’investigation des signes. Toutefois, il n’existe actuellement aucune échelle en français permettant d’identifier les enfants et les adolescents souffrant de troubles du comportement alimentaire de ce type. Le but de cette étude était de développer un autoquestionnaire en français qui permette un premier tri. Nous sommes partis des outils et critères provisoires proposés dans le monde anglophone. Le format de type autoquestionnaire exigeait de vérifier que les questions étaient bien comprises de la population cible. Dix-neuf adolescents âgés de 11 à 18 ans, de poids normal ou souffrant d’obésité, ont été interrogés sur leur manière d’appréhender le questionnaire, au moyen d’un guide d’entretien. Ainsi, les expressions et les termes mal compris ont pu être mis en évidence et reformulés. Ces résultats montrent la valeur ajoutée d’une évaluation des outils auprès de la population cible, en particulier adolescente. La validité discriminante de ce questionnaire sera testée en le comparant à un entretien clinique.

SummaryBinge eating disorder is often associated with obesity. It has many psychosocial and somatic consequences and affects obesity treatment outcome. Binge eating has been observed in very young populations. Studies have shown that complications associated with binge eating disorder can appear in children, even when all the criteria included in the definition of the disorder for adults are not met. Therefore, provisional criteria have been proposed to investigate binge eating disorder among children and adolescents. There is an urgent need to enhance the screening of binge eating disorder in the young population, first in order to document the disorder and second to allow for tailored treatment of these populations. Currently, there is no scale in French to detect this type of disorder among children or adolescents. The aim of this study was to develop a self-administered questionnaire in French, which could be used as a screening tool for binge eating disorder among adolescents. We have developed a self-administered questionnaire, based on a previous questionnaire and provisional criteria proposed in the English-speaking world. In the present study, we assessed how the target population understood the expressions used in the questionnaire and refined terminology according to the results. Nineteen adolescents aged 11–18 years (normal weight or with obesity) were interviewed about their understanding of the questionnaire, using a structured individual interview. After completing the questions on their own, because the goal was to end up with a self-administered tool, they were asked to explain their own understanding of each question and to reformulate the terms used. The results highlighted that some words or sentences were misunderstood by adolescents, and we developed more adequate formulations as a consequence. Some terms used in their figurative sense had to be modified. Respondents found it difficult to assess duration and frequency of their behavior and suggested changing the open-ended answers to categories. Over the course of answering the questionnaire, they tended to forget the context and related their answers to their general eating behavior. Therefore, the context (binging) was repeated in each question of the modified version. A self-administered questionnaire can be effective in detecting problematic eating behaviors among adolescents and is a good first step before a diagnosis clarification by a professional. Our results show the importance of development and evaluation with the target population. The discriminant validity of the questionnaire will be evaluated by comparison with an assessment by a professional in a further study.