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Prevalence, incidence, and natural course of anorexia and bulimia nervosa among adolescents and young adults

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Lieb,  Roselind
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Max Planck Institute of Psychiatry, Max Planck Society;

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Wittchen,  Hans-Ulrich
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Max Planck Institute of Psychiatry, Max Planck Society;

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Citation

Nagl, M., Jacobi, C., Paul, M., Beesdo-Baum, K., Hoefler, M., Lieb, R., et al. (2016). Prevalence, incidence, and natural course of anorexia and bulimia nervosa among adolescents and young adults. EUROPEAN CHILD & ADOLESCENT PSYCHIATRY, 25(8), 903-918. doi:10.1007/s00787-015-0808-z.


Cite as: http://hdl.handle.net/11858/00-001M-0000-002C-5A95-3
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.