The prevalence of eating disorders (EDs) and comorbid psychiatric disorders in adolescents: a two-stage community-based study

Abstract

Objective: The aims of this study were to determine the prevalence of eating disorders (EDs) in adolescents and the prevalence of comorbid psychiatric disorders in adolescents with EDs.

Method: During stage 1 of the study the Eating Attitude Test (EAT) was administered to 2907 randomly selected adolescent students. During stage 2 of the study students with an EAT score >30 underwent a clinical interview and those diagnosed with an ED (based on DSM-IV criteria) were included in the ED group. The control group included students that were age- and sex-matched with the ED group, were not diagnosed with an ED, and had an EAT score <30. Psychiatric comorbidity in the ED and control groups was evaluated using the Structured Clinical Interview for DSM-III-R (outpatient and non-patient forms). Additionally, a demographic data form, the Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI) were administered to all the participants.

Results: In total, 68 (9 male and 59 female) of the 2907 students met the diagnostic criteria for an ED. Point prevalence rates were as follows: anorexia nervosa: 0.034%; bulimia nervosa: 0.79%: eating disorder not otherwise specified: 1.51%; binge eating disorder: 0.99%; any ED: 2.33%. None of the male participants were diagnosed with anorexia nervosa or bulimia nervosa. In all, 8 male students were diagnosed with binge eating disorder. The prevalence of comorbid psychiatric disorders was higher in the ED group. Major depression was the most prevalent comorbid disorder in the ED group, followed by generalized anxiety disorder and social phobia. The body mass index, and BDI, BAI, and EAT scores were higher in the ED group than in the control group.

Conclusion: The results of this study show that whereas the point prevalence rate for EDs among all the participants was 2.3%, it was 4.03% among the female participants. Moreover, ED not otherwise specified was the most prevalent ED, and binge eating disorder was the most common ED among the males. The prevalence rates in the present study are similar to those observed in Western countries, except for the prevalence rate for anorexia nervosa, which in the present study was lower. Major depression and generalized anxiety disorder were the most prevalent comorbid disorders in the ED group.