Prevalence, comorbidities and outpatient treatment of anorexia and bulimia nervosa in German children and adolescents
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ORIGINAL ARTICLE
Prevalence, comorbidities and outpatient treatment of anorexia and bulimia nervosa in German children and adolescents Charlotte Jaite • Falk Hoffmann • Gerd Glaeske Christian J. Bachmann
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Received: 13 September 2012 / Accepted: 22 November 2012 / Published online: 16 April 2013 Springer International Publishing Switzerland 2013
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.
C. Jaite (&) Department of Child and Adolescent Psychiatry, Charite´ – Universita¨tsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany e-mail: [email protected] F. Hoffmann G. Glaeske Division Health Economics, Health Policy and Outcomes Research, Centre for Social Policy Research, University of Bremen, Bremen, Germany C. J. Bachmann Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Human Medicine, Philipps-University Marburg, Marburg, Germany
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. Keywords Adolescents Anorexia nervosa Bulimia nervosa Children Statutory health insurance
Introduction Eating disorders (EDs) are serious psychiatric disorders that are relatively common among adolescent girls and young women [1]. The point prevalence of anorexia nervosa (AN) according to DSM-IV criteria in 15- to 24-year-old females is estimated to be 0.29 %, while the lifetime prevalence is about 1.2–2.2 % [1, 2]. For bulimia nervosa (BN) in women, the reported point prevalence (DSM-III-R or DSM-IV criteria) is about 1 % and the lifetime prevalence is between 0.9 and 2.3 % (ICD-10, DSM-IV and DSM-5 criteria) [1, 2]. Partial EDs among adolescents are significantly more frequent with a prevalence of 10 to 15 % [3]. Epidemiologic stu
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