Prevalence, comorbidities and outpatient treatment of anorexia and bulimia nervosa in German children and adolescents

Eat Weight Disord. 2013 Jun;18(2):157-65. doi: 10.1007/s40519-013-0020-4. Epub 2013 Apr 16.

Abstract

Objective: This study aimed at investigating the prevalence, psychiatric comorbidity and outpatient treatment in a sample of German children and adolescents with eating disorders (EDs).

Method: Data of a large German statutory health insurance company were analysed and outpatients aged between 10 and 21 years with an ED diagnosis in 2009 were identified.

Results: Of 248,558 insured children and adolescents, 1,404 patients (79.9 % females, mean age: 16.7; SD: 3.3 years) matched the inclusion criteria. The large majority of patients with anorexia nervosa (AN) and bulimia nervosa (BN) were females (94.7 and 92.7 %), on which we focus in the following analyses. The prevalence in females was 0.28 % (AN) and 0.20 % (BN). Psychiatric comorbidity was diagnosed in 59.8 % (AN) and 64.1 % (BN) of patients, respectively. Most patients were treated with psychotherapy (AN: 75.7 %, BN: 78.5 %), 16.4 % (AN) and 20.2 % (BN) of our patients received pharmacotherapy with either antidepressants or antipsychotics. 23.5 % (AN) and 21.1 % (BN) received no treatment with psychotherapy, antidepressants or antipsychotics.

Discussion: This naturalistic study suggests that in young ED outpatients, EDs seem to be underdiagnosed and treatment does not necessarily comply with current guidelines. Therefore, dissemination of state-of-the-art knowledge on diagnosis and treatment in children and adolescents with EDs constitutes an important educational goal.

MeSH terms

  • Adolescent
  • Ambulatory Care
  • Anorexia Nervosa / epidemiology*
  • Anorexia Nervosa / psychology
  • Anorexia Nervosa / therapy
  • Anxiety Disorders / epidemiology*
  • Bulimia Nervosa / epidemiology*
  • Bulimia Nervosa / psychology
  • Bulimia Nervosa / therapy
  • Child
  • Comorbidity
  • Cross-Sectional Studies
  • Databases, Factual
  • Depressive Disorder / epidemiology*
  • Female
  • Germany / epidemiology
  • Humans
  • Outpatients
  • Prevalence
  • Somatoform Disorders / epidemiology*
  • Young Adult