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Free keywords:
Anorexia nervosa, Bulimia nervosa, Prevalence, Stability, Epidemiology
Abstract:
We aimed to assess the prevalence, incidence, age-of-onset and
diagnostic stability of threshold and subthreshold anorexia nervosa (AN)
and bulimia nervosa (BN) in the community. Data come from a
prospective-longitudinal community study of 3021 subjects aged 14-24 at
baseline, who were followed up at three assessment waves over 10 years.
Eating disorder (ED) symptomatology was assessed with the DSM-IV/M-CIDI
at each wave. Diagnostic stability was defined as the proportion of
individuals still affected with at least symptomatic eating disorders
(EDs) at follow-ups. Baseline lifetime prevalence for any threshold ED
were 2.9 % among females and 0.1 % among males. For any subthreshold ED
lifetime prevalence were 2.2 % for females and 0.7 % for males.
Symptomatic expressions of EDs (including core symptoms of the
respective disorder) were most common with a lifetime prevalence of 11.5
% among females and 1.8 % among males. Symptomatic AN showed the
earliest onset with a considerable proportion of cases emerging in
childhood. 47 % of initial threshold AN cases and 42 % of initial
threshold BN cases showed at least symptomatic expressions of any ED at
any follow-up assessment. Stability for subthreshold EDs and symptomatic
expressions was 14-36 %. While threshold EDs are rare, ED symptomatology
is common particularly in female adolescents and young women. Especially
threshold EDs are associated with a substantial risk for stability. A
considerable degree of symptom fluctuation is characteristic especially
for subthreshold EDs.
