Prevalence and Long-Term Course of Lifetime Eating Disorders in an Adult Australian Twin Cohort

School of Psychology, Flinders University, Adelaide, South Australia, Australia.
Australian and New Zealand Journal of Psychiatry (Impact Factor: 3.41). 03/2006; 40(2):121-8. DOI: 10.1111/j.1440-1614.2006.01758.x
Source: PubMed


Few studies exist that have examined the spectrum and natural long-term course of eating disturbance in the community. We examine the lifetime prevalence and long-term course of anorexia nervosa (AN), bulimia nervosa (BN) and eating disorder not otherwise specified (EDNOS) in an adult female twin population.
Female twins (n = 1002) from the Australian Twin Registry, aged 28-39 years, were assessed using the Eating Disorder Examination, revised to yield lifetime diagnostic information. For women with lifetime eating disorders, the assessment occurred, on average, 14.52 years (SD = 5.65) after onset of their disorder.
In accordance with other community studies, we found a 1.9% lifetime prevalence of AN, with an additional 2.4% who met the criteria for 'partial AN' (absence of amenorrhea). Criteria for BN were met by 2.9% of the women, an additional 2.9% of women met criteria for binge eating disorder, while 5.3% met criteria for purging disorder unaccompanied by binge eating (EDNOS-p). Eleven (7%) of the women with lifetime eating disorders had a current eating disorder. Each diagnostic group continued to be differentiated by current eating pathology from women without lifetime eating disorders. Although approximately 75% of the women had a good outcome, less than 50% of each diagnostic group was asymptomatic.
Eating disorders tend to improve over time often reaching subdiagnostic levels of severity, but only a minority of sufferers becomes asymptomatic. The DSM-IV diagnosis EDNOS needs to be considered in studies of the prevalence and course of eating disorders.

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    • "Eating disorders are not the 'preserve' of females, the wealthy or 'westerners'. In the general population, lifetime prevalence of anorexia nervosa is around 1% in women and < 0.5% in men, bulimia nervosa around 2% in women and 0.5% in men, and binge eating disorder around 3.5% in women and 2.0% in men (Favaro et al., 2003; Hudson et al., 2007; Keski-Rahkonen et al., 2007; Lewinsohn et al., 2000; Oakley Browne et al., 2006; Preti et al., 2009; Raevuori et al., 2009; Striegel-Moore et al., 2003; Wade et al., 2006). Point (three-month) prevalence in Australia is estimated at around 1% for bulimia nervosa, 2% for binge eating disorder (using the DSM-5 criteria of weekly frequency of binge eating and extreme weight control behaviours) and 3% for other eating disorders (specified or unspecified according to the new DSM-5 criteria) (Hay et al., 2008). "
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