Hoek HW. Incidence, prevalence and mortality of anorexia nervosa and other eating disorders. Curr Opin Psychiatry 19: 389-394

Parnassia Psychiatric Institute, The Hague, The Netherlands.
Current Opinion in Psychiatry (Impact Factor: 3.94). 08/2006; 19(4):389-94. DOI: 10.1097/01.yco.0000228759.95237.78
Source: PubMed


The purpose of this review is to evaluate the recent literature on the incidence and prevalence of and mortality associated with eating disorders.
General-practice studies show that the overall incidence rates of anorexia nervosa remained stable during the 1990s, compared with the 1980s. Some evidence suggests that the occurrence of bulimia nervosa is decreasing. Anorexia nervosa is a common disorder among young white females, but is extremely rare among black females. Recent studies confirm previous findings of the high mortality rate within the anorexia nervosa population.
The incidence of anorexia nervosa is around eight per 100,000 persons per year. An upward trend has been observed in the incidence of anorexia nervosa in the past century till the 1970s. The most substantial increase was among females aged 15-24 years, for whom a significant increase was observed from 1935 to 1999. The average prevalence rates for anorexia nervosa and bulimia nervosa among young females are 0.3 and 1%, respectively. Only a minority of people with eating disorders, especially with bulimia nervosa, are treated in mental healthcare.

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Available from: Hans Wijbrand Hoek, Jul 24, 2014
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    • "This would have resulted in an increase in detection rates of eating disorders rather than a decrease, which was indeed our expectation at the start of the second and third study periods. With respect to case definition, consistency of classification was ensured by applying DSM-IV criteria to all GP records of possible cases; including, in retrospect , to the records of the first study period, which had originally been evaluated using DSM-III-R criteria (Hoek et al. 1995; van Son et al. 2006a). Another potential bias is a change over time in the case definition process by the research clinicians. "
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    ABSTRACT: Background: Whether the incidence of eating disorders in Western, industrialized countries has changed over time has been the subject of much debate. The purpose of this primary-care study was to examine changes in the incidence of eating disorders in The Netherlands during the 1980s, 1990s and 2000s. Method: A nationwide network of general practitioners (GPs), serving a representative sample (~1%) of the total Dutch population, recorded newly diagnosed patients with anorexia nervosa (AN) and bulimia nervosa (BN) in their practice during 1985-1989, 1995-1999, and 2005-2009. GPs are key players in the Dutch healthcare system, as their written referral is mandatory in order to get access to specialized (mental) healthcare, covered by health insurance. Health insurance is virtually universal in The Netherlands (99% of the population). A substantial number of GPs participated in all three study periods, during which the same case identification criteria were used and the same psychiatrist was responsible for making the final diagnoses. Incidence rates were calculated and for comparison between periods, incidence rate ratios. Results: The overall incidence rate of BN decreased significantly in the past three decades (from 8.6 per 100 000 person-years in 1985-1989 to 6.1 in 1995-1999, and 3.2 in 2005-2009). The overall incidence of AN remained fairly stable during three decades, i.e. 7.4 per 1 00 000 person-years in 1985-1989, 7.8 in 1995-1999, and 6.0 in 2005-2009. Conclusions: The incidence rate of BN decreased significantly over the past three decades, while the overall incidence rate of AN remained stable.
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    • "Attention deficit hyperactivity disorder (ADHD) is more commonly diagnosed in males than females, with male-to-female ratios ranging from 4 : 1 to 9 : 1 [29]. Eating disorders, which are one of the most important psychiatric categories of the behavioral aspects of PWS, are more common among females than males in both anorexia nervosa and bulimia nervosa [30] [31]. "
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    ABSTRACT: Objectives . This study measured gender differences in Prader-Willi syndrome (PWS) in regard to the severity of behavioral symptoms. Methods . The Food Related Problem Questionnaire (FRPQ), the Aberrant Behavior Checklist Japanese Version, the Childhood Routines Inventory, the Pervasive Developmental Disorders Autism Society Japan Rating Scale, and Japanese ADHD-RS were administered to PWS patients (45 males aged 6 to 58 and 37 females aged 6 to 45). To examine the effects that gender and genotype have on the severity of each symptom, two-way ANOVAs were conducted. Results . Significant interactions were found only in regard to FRPQ scores, such as FRPQ total score ( F ( 1 , 78 ) = 8.43, p < 0.01 ). The FRPQ of male deletion (DEL) individuals was higher than that of female DEL and male mUPD. The FRPQ of male maternal uniparental disomy (mUPD) was lower than that of female mUPD. Conclusions . In terms of problem behaviors, routines, autistic behaviors, and hyperactivity, no significant differences were found. Food-related behaviors in DEL were more severe in males, although those in mUPD were less severe in males.
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    • "Eating disorders (ED) are usually considered a feminine pathology (Darcy & Lin, 2012; Striegel-Moore & Bulik, 2007), where the prevalence of male cases is considerably lower (Hoek, 2006). However, in many cases, men with ED go undetected because their problem is unknown and assessment is not always properly performed (Strother, Lemberg, Stanford, & Turberville, 2012). "
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    ABSTRACT: Eating disorders (ED) are usually considered a feminine pathology (Darcy & Lin, 2012; Striegel-Moore & Bulik, 2007), where the prevalence of male cases is considerably lower (Hoek, 2006). However, in many cases, men with ED go undetected because their problem is unknown and assessment is not always properly performed.
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