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A two-stage epidemiological study of abnormal eating attitudes and their prospective risk factors in Polish schoolgirls

  • Katarzyna Włodarczyk-Bisaga (a1) and Bridget Dolan (a1)

In this longitudinal two-stage screening study of abnormal eating attitudes and behaviours in Polish schoolgirls self-report questionnaires (EAT-26) were completed by 747 schoolgirls aged between 14 and 16 years. On the basis of their EAT-26 scores 167 girls were selected for a clinical interview conducted blind to questionnaire scores. No clinical cases of DSM-III-R anorexia or bulimia nervosa were identified, however, there was a point prevalence of 2·34% for subclinical eating disorder and of 28·6% for dieting. Natural history was investigated, repeating the screening and interviews after 10 months. Both the group mean EAT-26 score and the proportion of subclinical cases remained the same at follow-up however, individual girls showed substantial fluctuations over time. On re-screening 11·5% of the sample had moved EAT category (based on scoring below or above the clinical cut-off point). Follow-up interviews showed that 58% (7) of the original subclinical cases were no longer cases while seven girls were ‘new’ subclinical cases. This second stage of the study also aimed to investigate the risk factors for the development of eating disorders. Several family factors distinguished the dieters from non-dieters at the initial stage. Subjects who began dieting between the initial and follow-up interviews had higher Body Mass Index, felt more overweight and had greater discrepancy between their current and ideal weights than the non-dieters. However, analysis of regression revealed no specific risk factors for development of a subclinical syndrome.

Corresponding author
1Address for correspondence: Dr Bridget Dolan Department of Mental Health SciencesSt George's Hospital Medical SchoolTootingLondon SW17 0RE.
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American Psychiatric Association (1987). Diagnostic and Statistical Manual of Mental Disorders (3rd edn. revised). American Psychiatric Association: Washington, DC.
Banas A., Januszkiewicz-Grabias A., Majkowicz M. & Bojs B. (1991). Anorexia nervosa w aspekcie psychiatrycznym i psychologicznym. Psychiatria Polska 14, 3640.
Bomba J. (1981). Depresja mlodziencza. In Zaburzenia psychiciczne u mlodziety (ed. Orwid M.), pp. 119138) PZWL: Warszawa.
Bomba J., Mamrot E. & Orwid M. (1981). Anorexia nervosa. In Zaburzenia psychiczne u dzieci i mlodziezy (ed. Orwid M.), pp. 150165. PZWL: Warszawa.
Button E. J. & Whitehouse A. (1981). A subclinical anorexia nervosa. Psychological Medicine 11, 509516.
Dolan B. M. (1991). Cross cultural aspects of anorexia nervosa and bulimia nervosa: a review. international Journal of Eating Disorders 10, 6769.
Dolan B. M. & Gitzinger I. (1994). Why Women? Gender Issues in Eating Disorders 2nd edn.Athlone Press: London.
Dolan B. M., Evans C. D. H. & Lacey J. H. (1989). Family composition and social class in bulimia: A catchment area study of a clinical and a comparison group. Journal of Nervous and Mental Diseases 177, 267272.
Dolan B. M., Lieberman S. L., Lacey J. H. & Evans C. D. H. (1990). Family features associated with normal body weight bulimia. International Journal of Eating Disorders 9 638647.
Faltus F. (1985). Prvni zkusenosti s jednotkou specializované pece pro mentalni anorexic Csechoslovakia Psychiatrie 81, 374380.
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 R., Garfinkel P., Garner D. and Coscina D.), pp. 95105. Liss: New York.
Fornair V., Kaplan M., Sandberg D. & Matthews M. (1992). Depressive and anxiety disorders in anorexia nervosa and bulimia nervosa. International Journal of Eating Disorders 12, 2129.
Garner D. M. & Garfinkel P. E. (1980). Socio-cultural factors in the development of anorexia nervosa. Psychological Medicine 10, 647656.
Garner D. M. & Wooley S. (1991). Confronting the failure of behavioural and dietary treatments for obesity. Clinical Psychology Review 11, 729780.
Garner D. M., Olmstead M. P., Bohr Y. & Garfinkel P. E. (1982). The Eating Attitudes Test: psychometric features and clinical correlates. Psychological Medicine 12, 871878.
Gordon R. (1990). Anorexia and Bulimia, Anatomy of a Social Epidemic Basil Blackwell Ltd: Edinburgh.
Halmi K., Casper R., Eckert E., Goldberg D. & Davis J. (1979). Unique features associated with age of onset in anorexia nervosa. Psychiatric Research 1, 209215.
Hoek H. (1991). The incidence and prevalence of anorexia nervosa and bulimia nervosa in primary care. Psychological Medicine 21, 455460.
Huenemann R. L., Shapiro L. R., Hampton M. C. & Mitchell B. W. (1966). A longitudinal study of gross body composition and body conformation and their association with food and activity in the teenage population. American Journal of Clinical Nutrition 18, 325388.
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.
King M. (1989). Eating Disorders in a General Practice Population: Prevalence, Characteristics and Follow-up at 12–18 months. Psychological Medicine Monograph Supplement 14. Cambridge. University Press: Cambridge.
Komender J., Popielarska A. & Popielarska M. (1980). Niektore aspekty leczenia jadlowstretu psychicznego. Psychiatria Polska 14, 235240.
Korkina M. V., Tsyvilko M. A., Marilov V. V. & Kareva M. A. (1992). Anorexia nervosa as manifested in Russia. International Journal of Psychosomatics 39, 3541.
Koszewska I. & Sredniawa H. (1990). Bulimia. Psychiatria Polska 14, 165170.
Krch F. D. (1991). Epidemiologié des troubles des conduites alimentaires en Tchécoslovaquie. Neuropsychiatrie de l'Enfance 39, 311322.
Lacey J. H., Gowers S. & Bhat A. (1991). Bulimia nervosa: family size, sibling sex and birth order: a catchment area study. British Journal of Psychiatry 158, 491494.
Mumford D. B., Whitehouse A. M. & Platts M. (1991). Eating disorders amongst Asian schoolgirls in Bradford: prevalence and socio-cultural correlates. 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.
Neumarker U., Dudeck U., Vollrath M., Neumarker K-J. & Steinhausen H. C. (1992). Eating attitudes among adolescent anorexia nervosa patients and normal subjects in former West and East Berlin: a transcultural comparison. International Journal of Eating Disorders 12, 281289.
Orwid M. (1987). Psychiatria młodziezowa. In Psychiatria (ed. Dąbrowski S., Jarószyński J. and Puzyński S.), pp. 397427. PZWL: Warsaw.
Patton G., Sabine-Johnson E., Wood K., Mann A. & Wakeling A. (1990). Abnormal eating attitudes in London schoolgirls – a prospective epidemiological study. Psychological Medicine 20, 383394.
Polivy J. & Herman P. (1987). Diagnosis and treatment of normal eating. Journal of Consulting Clinical Psychology 55, 635644.
Popielarska A. (1989). Reackje nerwicowe, nerwicwe i zespoly nerwicowe u dzieci i mlodziezy. In Psychiatria Wieku Rozowojowego (ed. Popielarska A.), pp. 8084. PZWL: Warszawa.
Pumariega A. J. (1986). Acculturation and eating attitudes in adolescent girls. Journal of the American Academy of Child and Adolescent Psychiatry 25, 276279.
Rathner G. (1992). Aspects of the natural history of normal and disordered eating: some methodological considerations. In The Course of Eating Disorders (ed. Herzog W., Deter H. C. and Vandereycken W.), pp. 273303. Springer Verlag: Heidelberg.
Rathner G. & Messner K. (1993). Detection of eating disorders in a small rural town: an epidemiological study. Psychological Medicine 23, 175184.
Rathner G., Túry F., Szabó P., Geyer M., Rumpold G., Forgács A., Söllner W. & Plöttner G. (1995). Prevalence of eating disorders and minor psychiatric morbidity in Central Europe before the political changes in 1989: a cross-cultural study. Psychological Medicine 25, 10271035.
Rosen J. C., Tacy B. & Howell D. (1990). Life stress, psychological symptoms and weight reducing behaviour in adolescent girls. International Journal of Eating Disorders 9, 1726.
Schleimer K. (1983). Dieting in teenage schoolgirls: a longitudinal prospective study. Acta Paediatrica Scandinavica (suppl. 312), 1–54.
Sobczynska Z. (1971). Jadlowstret psychiczny. Psychiatria Polska 5, 511516.
Steinhausen H. C., Neumarker K-J., Vollrath M., Dudeck U. & Neumarker U. (1992). A transcultural comparison of the Eating Disorder Inventory in former West and East Berlin. International Journal of Eating Disorders 12, 407416.
Strober M. & Katz J. L. (1987). Do eating disorders and affective disorders have a common etiology? International Journal of Eating Disorders 6, 171180.
Sulestrowska H. & Szlykowicz J. K. (1971). Aspekt leczniczy i prognostyczny tzw anoreksji nerwowej. Psychiatria Polska 5, 517524.
Suffczynska-Kotowska M. (1989). Zaburzenia psychosomatyczne. Jadlowstret psychiczny. In Psychiatria wieku rozwojowego (ed. Popielarska A.), pp. 105112. PZWL: Warszawa.
Szabó P. & Túry F. (1991). The prevalence of bulimia nervosa in a Hungarian College and secondary school population. Psychotherapy and Psychosomatics 56, 4347.
Túry F. & Szabó P. (1990). Hypnotherapy in a special dissociative state nocturnal bulimia: a case study. Hypnos XVII, 155161.
Vandereycken W. & Vanderlinden J. (1983). Denial of illness and the use of self-reporting measures. International Journal of Eating Disorders 2, 101108.
Whittaker A., Davies M., Shaffer D., Johnson J., Abrams S., Walsh B. T. & Kalikow K. (1989). The struggle to be thin: a survey of anorexic and bulimic symptoms in a non-referred adolescent population. Psychological Medicine 19, 143163.
Williams P., Tarnopolsky A. & Hand D. (1980). Case identification in psychiatric epidemiology: review and assessment. Psychological Medicine 10, 101114.
Włodarczyk-Bisaga K., Dolan B. M., McCluskey S. & Lacey J. H. (1995). Disordered eating behaviour and attitudes towards weight and shape in Polish women. European Eating Disorders Review 3, 205216.
Zok-Jaroszewska U. (1988 a). Kliniczne i psychologiczne aspekty anorexia nervosa. Psychoterapia 3, 716.
Zok-Jaroszewska U. (1988 b). Leczenie anorexia nervosa w oddziale nerwic. Psychoterapia 3, 1726.
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