SCOFF, the development of an eating disorder screening questionnaire

Int J Eat Disord. 2010 May;43(4):344-51. doi: 10.1002/eat.20679.


Objective: This article describes the three-stage development of the SCOFF, a screening tool for eating disorders.

Method: Study 1 details questionnaire development and testing on cases and controls. Study 2 examines reliability of verbal versus written administration in a student population. Study 3 validates the test as a screening tool in primary care.

Results: The SCOFF demonstrates good validity compared with DSM-IV diagnosis on clinical interview. In the primary care setting it had a sensitivity of 84.6% and a specificity of 89.6%, detecting all true cases of anorexia nervosa and bulimia nervosa and seven of nine cases of EDNOS. Reliability between written and verbal versions of the SCOFF was high, with a kappa statistic of 0.82.

Discussion: The SCOFF, which has been adapted for use in diverse languages, appears highly effective as a screening instrument and has been widely adopted to raise the index of suspicion of an eating disorder.

MeSH terms

  • Adolescent
  • Adult
  • Anorexia Nervosa / diagnosis*
  • Anorexia Nervosa / epidemiology*
  • Anorexia Nervosa / psychology
  • Body Mass Index
  • Bulimia Nervosa / diagnosis*
  • Bulimia Nervosa / epidemiology*
  • Bulimia Nervosa / psychology
  • Cross-Sectional Studies
  • England
  • Feeding and Eating Disorders / diagnosis*
  • Feeding and Eating Disorders / epidemiology*
  • Feeding and Eating Disorders / psychology
  • Female
  • Humans
  • Mass Screening / statistics & numerical data*
  • Primary Health Care
  • Psychometrics / statistics & numerical data
  • Reproducibility of Results
  • Surveys and Questionnaires*
  • Young Adult