Clinical Epidemiology of Eating Disorders: Results from the Sesto Fiorentino Study

Abstract

Background: It is speculated that clinical samples do not fully reflect the characteristics of eating disorders (EDs) as they are in the general population, especially in their lowest range of severity. The present article reports the prevalence of EDs in a community sample aged >14 years, their clinical and psychopathological features, and their course and outcome on naturalistic grounds. Methods: The Sesto Fiorentino Study is a three-phase community-based survey where 2,355 out of 2,500 people representative of the population aged >14 years living in Sesto Fiorentino were evaluated by their own general practitioner using the Mini International Neuropsychiatric Interview plus six additional questions. All those who had positive results plus a probability sample of the non-cases were re-interviewed by psychiatrists using the Florence Psychiatric Interview. The subjects who reported ED symptoms were subsequently administered the Eating Disorder Examination (12th edition). Results: Overall, the lifetime prevalence of EDs was 1.21%. More precisely, 0.42% had anorexia nervosa, 0.32% bulimia nervosa, 0.32% binge eating disorder and 0.32% eating disorder not otherwise specified. All the subjects suffering from an ED fulfilled diagnostic criteria for at least another DSM-IV axis I psychiatric disorder. At the moment of the interview, conducted a few years (average 7 years) after the onset of the disorder, 50% had fully recovered from EDs, 26.9% were currently affected by an ED, 23.1% showed a persistent body image disturbance and/or the presence of compensatory behaviours. Conclusions: Community surveys conducted by clinicians may provide useful additional information on the psychopathological features, natural course and outcome of these disorders on naturalistic grounds.

The developmental effects of media-ideal internalization and self-objectification processes on adolescents’ negative body-feelings, dietary restraint, and binge eating

“…In line with scholars' recommendations [2,4] and prior research [33,50], binge eating was conceptualized as a categorical variable, that is, as absent or present (i.e., ≥1 of an either OBE or SBE) in the month prior to the T4 assessment. Seventy-eight participants reported binge eating at T4, with 44 and 34 reporting SBE and OBE, respectively; the percentage and mean of SBE and OBE episodes (see Table 1) are close to those reported in other Italian studies of community samples of 17-18-year-old women and men [67,68]. As noted (see Footnote 1) participants who reported binge eating in the month prior to the T1 (N = 7), T2 (N = 15), and T3 (N = 36) assessments were excluded from (main) analyses; thus, the final sample included data from 627 adolescents (327 girls and 300 boys).…”

The epidemiology of eating disorders in six European countries: Results of the ESEMeD-WMH project

“…In the NEMESIS study, which used a previous version of CIDI, lifetime prevalence for anorexia and bulimia nervosa in Netherlands were twice as high as those presently reported (Bijl et al, 1998). In the Sesto Fiorentino study, based on the Mini International Neuropsychiatric Interview administered to 2355 respondents representative of the population aged above 14 years living in Sesto Fiorentino (near Florence, Italy), the estimated lifetime prevalence was 0.42% for anorexia nervosa, 0.32% for bulimia nervosa, and 0.32% binge ED, with the majority of cases among females (Faravelli et al, 2006). In that study, however, a much higher proportion of subjects (90-100%) meeting the criteria for any ED consulted their general practitioner than in this study, and more than 50% contacted a psychiatrist or a psychologist for their disorder.…”

The Epidemic of Anorexia Nervosa: Myth or Reality?

“…In addition to quantifying the occurrence of AN, population studies can also provide data on the distribution of the age-of-onset, natural course, and medical outcomes of this disease (Faravelli et al, 2006;Hudson et al, 2007). For this reason, lifetime prevalence is often reported.…”

“…Hudson et al, 2007;Lahortiga-Ramos et al, 2005) but in some cases the interview is integrated in the first stage of the screening (cf. Faravelli et al, 2006;Preti et al, 2009). Other works have adopted the clinical interview as a main procedure, applying it to the whole sample (cf.…”

“…Most of the studies select participants from a limited geographic area, most often in an urban area (cf. Faravelli et al, 2006;Favaro et al, 2003;Lahortiga-Ramos et al, 2005;Robins et al, 1984); while others use larger, nationally representative community samples (cf. Ghaderi & Scott, 2001;Götestam & Agras, 1995;Hudson et al, 2005;Preti et al, 2009;Wade et al, 2006).…”