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Detection of eating disorders in a small rural town: an epidemiological study

  • Günther Rathner (a1) and Klara Messner (a1)
Synopsis
Synopsis

The occurrence of eating disorders among 517 school girls (11 to 20 years of age) in a small rural Italian town was studied using a three-stage prospective procedure. The screening stage was aimed at defining risk and sub-risk groups. One year later, the risk group (N = 44) and a random sample of the sub-risk (N = 25) and of the screen-negative group (N = 32) were interviewed to detect cases of anorexia/bulimia nervosa. The case registers of four hospitals over a period of 3 years were investigated to detect any additional cases that may have been overlooked in the survey. A minimum point prevalence rate of 1·30% clinical anorexia nervosa, 1·30 % sub-clinical anorexia nervosa and 0·87 % sub-clinical bulimia nervosa was found for age 15 and above. No case of clinical bulimia nervosa was detected. For age 15 and below no clinical or sub-clinical cases were found. All cases of (sub-)clinical eating disorder initially belonged to the predefined sub-risk and risk groups. Because of the low positive predictive value of any single risk factor, this study shows that early case detection can be improved by using multiple risk indices. In this rural area the prevalence was as high as in metropolitan or urban areas. Urban–rural differences should be assessed in further studies.

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Corresponding author
1Address for correspondence: Dr Günther Rathner, Department of Paediatrics, University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria.
References
Hide All
American Psychiatric Association (1987). DSM-III-R. APA: Washington, DC.
Azuma Y. & Henmi M. (1982). A study on the incidence of anorexia nervosa in school girls. Annual Report of the Research Group into Eating Disorders, Japan, 3034.
Barrett J. (1986). Case identification by category validation: The challenge of disorder-specific assessment. In Mental Disorders in the Community: Progress and Challenge (ed. Barrett J. E. and Rose R. M.), pp. 219242. Guilford: New York.
Blazer D., Crowell B. A., George L. K. & Landerman R. (1986). Urban-rural differences in depressive disorders: does age make a difference? In Mental Disorders in the Community: Progress and Challenge (ed. Barrett J. E. and Rose R. M.), pp. 3246. Guilford: New York.
Carter P. I. & Moss R. A. (1984). Screening for anorexia and bulimia nervosa in a college population: Problems and limitations. Addictive Behaviors 9, 417419.
Costello E. J. (1990). Child psychiatric epidemiology. Implications for clinical research and practice. In Advances in Clinical Child Psychology, vol. 13 (ed. Lahey B. B. and Kazdin A. E.), pp. 5390. Plenum Press: New York.
Cox A., Rutter M., Yule B. & Quinton D. (1977). Bias resulting from missing information: some epidemiological findings. British Journal of Preventive and Social Medicine 31, 131136.
Crisp A. H., Palmer R. L. & Kalucy R. S. (1976). How common is anorexia nervosa? A prevalence study. British Journal of Psychiatry 128, 549554.
Cullberg J. & Engström-Lindberg M. (1988). Prevalence and incidence of eating disorders in a suburban area. Acta Psychiatrica Scandinavica 78, 314319.
Diem K. (1968). Documenta Geigy: Scientific Tables (7th edn). Geigy: Basle, Switzerland.
Dohrenwend B. P. & Dohrenwend B. S. (1974). Social and cultural influences on psychopathology. Annual Review of Psychology 25, 417452.
Eisler I. & Szmukler G. I. (1985). Social class as a confounding variable in the Eating Attitudes test. Journal of Psychiatric Research 19, 171176.
Fairburn C. G. & Beglin S. J. (1990). Studies of the epidemiology of bulimia nervosa. American Journal of Psychiatry 147, 401408.
Fichter M. M. (1985). Strukturiertes Interview zur Anorexia nervosa (SIAN-EX). University of Munich, Internal Technical Report.
Fichter M. M. & Keeser W. (1980). Das Anorexia-nervosa-lnventar zür Selbstbeurteilung (ANIS). Archiv der Psychiatrie und Nervenkrankheiten 228, 6789.
Fichter M. M., Wegerer S., Sourdi L. & Sourdi Z. (1983). The epidemiology of anorexia nervosa: a comparison of Greek adolescents living in Germany and Greek adolescents living in Greece. In Anorexia Nervosa: Recent Developments in Research (ed. Darby P. L., Garfinkel P. M., Garner D. M. and Coscina D. V.), pp. 95105. Liss: New York.
Fichter M. M., Elton M., Sourdi L., Weyerer S. & Koptagel-Ilal G. (1988). Anorexia nervosa in Greek and Turkish adolescents. European Archives of Psychiatry and Neurological Sciences 237, 200208.
Garner D. M. & Garfinkel P. E. (1979). The Eating Attitudes Test: an index of the symptoms of anorexia nervosa. Psychological Medicine 9, 273279.
Hoek H. W. (1991). The incidence and prevalence of anorexia nervosa in primary care. Psychological Medicine 21, 455460.
Johnson-Sabine E., Wood K., Patton G., Mann A. & Wakeling A. (1988). Abnormal eating attitudes in London schoolgirls – a prospective epidemiological study: factors associated with abnormal response on screening questionnaires. Psychological Medicine 18, 615622.
Jones D. J., Fox M. M., Babigian H. M. & Hutton H. E. (1980). Epidemiology of anorexia nervosa in Monroe County. New York: 1960–1976. Psychosomatic Medicine 42, 551558.
King M. (1989). Eating disorders in a General Practice Population. Prevalence, Characteristics and Follow-up at 12 to 18 Months. Psychological Medicine Monograph Supplement 14, 134.
King M. & Bhugra D. (1989). Eating disorders: lessons from a cross-cultural study. Psychological Medicine 19, 955958.
Leichner P., Arnett J., Rallo J. S., Srikameswaran S. & Vulcano B. (1986). An epidemiologic study of maladaptive eating attitudes in a Canadian school age population. International Journal of Eating Disorders 5, 969982.
Lucas A. R., Beard C. M., O'Fallon W. M. & Kurland L.T. (1988). Anorexia nervosa in Rochester, Minnesota: a 45-year study. Mayo Clinics Proceedings 63, 433442.
Mann A. H., Wakeling A., Wood K., Monck E., Dobbs R. & Szmukler G. (1983). Screening for abnormal eating attitudes and psychiatric morbidity in an unselected population of 15-year-old school girls. Psychological Medicine 13, 573580.
Meller I., Fichter M. M. & Weyerer S. (1986). Use of psychiatric facilities in the upper Bavarian follow-up field study. European Archives of Psychiatry and Neurological Sciences 236, 8893.
Mumford D. B., Whitehouse A. M. & Platts M. (1991). Socio-cultural correlates of eating disorders among Asian schoolgirls in Bradford. British Journal of Psychiatry 158, 222228.
Nasser M. (1986). Comparative study of the prevalence of abnormal eating attitudes among Arab female students of both London and Cairo Universities. Psychological Medicine 16, 621625.
Nielsen S. (1990). The epidemiology of anorexia nervosa in Denmark from 1973 to 1987: a nationwide register study of psychiatric admission. Acta Psychiatrica Scandinavica 81, 507514.
Nylander I. (1971). The feeling of being fat and dieting in a school population. Acta Sociomedica Scandinavica 1, 1726.
Offord D. R., Boyle M. H. & Racine Y. (1989). Ontario Child Health Study: correlates of disorder. Journal of the American Academy of Child and Adolescent Psychiatry 28, 856860.
Ohzeki T., Hanaki K, Motozumi H., Ishitani N., Matsuda-Ohdahara H., Sunaguchi M. & Shiraki K. (1990). Prevalence of obesity, leanness and anorexia nervosa in Japanese boys and girls aged 12–14 years. Annals of Nutrition and Metabolism 34, 208212.
Patton G. C., Johnson-Sabine E., Wood K., Mann A. H. & Wakeling A. (1990). Abnormal eating attitudes in London schoolgirls – a prospective epidemiological study: outcome at twelve month follow-up. Psychological Medicine 20, 383394.
Pyle R. L. (19831985). The epidemiology of eating disorders. Pediatrician 12, 102109.
Rastam M., Gillberg C. & Garton M. (1989). Anorexia nervosa in a Swedish urban region: a population-based study. British Journal of Psychiatry 155, 642646.
Rutter M. (1989). Isle of Wight revisited. Twenty-five years of child psychiatric epidemiology. Journal of the American Academy of Child and Adolescent Psychiatry 28, 633653.
Schlaf G. & Pudel V. (1983). Referenzgewichte für deutsche Kinder und Jugendliche. Mit einer Darstellung für den praktischen Gebrauch. Aktuelle Ernährung 8, 235240.
Schleimer K. (1983). Dieting in teenage girls. Acta Paediatrica Scandinavica suppl. 312.
Sobal J. & Stunkard A. J. (1989). Socioeconomic status and obesity: A review of the literature. Psychological Bulletin 105, 260275.
Steinhausen H. C. (1984). Transcultural comparison of eating attitudes in young females and anorectic patients. European Archives of Psychiatry and Neurological Sciences 234, 198201.
Szmukler G. I. (1983). Weight and food preoccupation in a population of English school girls. In Understanding Anorexia Nervosa and Bulimia (ed. Bargman G. J.), pp. 2127. 4th Ross Conference on Medical Research.Ross Laboratories:Columbus, OH.
Szmukler G. I. (1985). The epidemiology of anorexia and bulimia. Journal of Psychiatric Research 19, 143153.
Theander S. (1970). A psychiatric investigation of 94 female patients. Acta Psychiatrica Scandinavica suppl. 214.
Vandereycken W. & Vanderlinden J. (1983). Denial of illness and the use of self-reporting measures in anorexia nervosa patients. International Journal of Eating Disorders 2, 101107.
Wells J. E., Coope P. A., Gabb D. C. & Pears R. K. (1985). The factor structure of the Eating Attitudes Test with adolescent school girls. Psychological Medicine 15, 141146.
Whitaker A., Johnson J., Shaffer D., Rapoport J. L., Kalikow K., Walsh B. T., Davies M., Braiman S. & Dolinsky A. (1990). Uncommon troubles in young people: prevalence estimates of selected psychiatric disorders in a nonreferred adolescent population. Archives of General Psychiatry 47, 487496.
Willi J., Giacometti G. & Limacher B. (1990). Update on the epidemiology of anorexia nervosa in a defined region of Switzerland. American Journal of Psychiatry 147, 15141517.
Williams P. & King M. (1987). The ‘epidemic’ of anorexia nervosa: another medical myth? Lancet i, 205207.
Williams P., Hand D. & Tarnoplosky A. (1982). The problem of screening for uncommon disorders – a comment on the Eating Attitudes Test. Psychological Medicine 12, 431434.
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