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Prevalence of eating disorders and minor psychiatric morbidity in Central Europe before the political changes in 1989: a cross-cultural study

Published online by Cambridge University Press:  09 July 2009

G. Rathner ,
F. Túry ,
P. Szabó ,
M. Geyer ,
G. Rumpold ,
A. Forgács ,
W. Söllner  and
G. Plöttner
G. Rathner*
Affiliation:
Departments of Pediatrics and Medical Psychology & Psychotherapy, Leopold Franzens University of Innsbruck, Austria; Department of Psychiatry, Borsod County Hospital, Miskolc, Department of Psychology, Kossuth Lajos University of Debrecen and Department of Obstetrics and Gynecology, University of Debrecen Medical School, Hungary; Department of Psychotherapy & Psychosomatic Medicine, University of Leipzig, Germany
F. Túry
Affiliation:
Departments of Pediatrics and Medical Psychology & Psychotherapy, Leopold Franzens University of Innsbruck, Austria; Department of Psychiatry, Borsod County Hospital, Miskolc, Department of Psychology, Kossuth Lajos University of Debrecen and Department of Obstetrics and Gynecology, University of Debrecen Medical School, Hungary; Department of Psychotherapy & Psychosomatic Medicine, University of Leipzig, Germany
P. Szabó
Affiliation:
Departments of Pediatrics and Medical Psychology & Psychotherapy, Leopold Franzens University of Innsbruck, Austria; Department of Psychiatry, Borsod County Hospital, Miskolc, Department of Psychology, Kossuth Lajos University of Debrecen and Department of Obstetrics and Gynecology, University of Debrecen Medical School, Hungary; Department of Psychotherapy & Psychosomatic Medicine, University of Leipzig, Germany
M. Geyer
Affiliation:
Departments of Pediatrics and Medical Psychology & Psychotherapy, Leopold Franzens University of Innsbruck, Austria; Department of Psychiatry, Borsod County Hospital, Miskolc, Department of Psychology, Kossuth Lajos University of Debrecen and Department of Obstetrics and Gynecology, University of Debrecen Medical School, Hungary; Department of Psychotherapy & Psychosomatic Medicine, University of Leipzig, Germany
G. Rumpold
Affiliation:
Departments of Pediatrics and Medical Psychology & Psychotherapy, Leopold Franzens University of Innsbruck, Austria; Department of Psychiatry, Borsod County Hospital, Miskolc, Department of Psychology, Kossuth Lajos University of Debrecen and Department of Obstetrics and Gynecology, University of Debrecen Medical School, Hungary; Department of Psychotherapy & Psychosomatic Medicine, University of Leipzig, Germany
A. Forgács
Affiliation:
Departments of Pediatrics and Medical Psychology & Psychotherapy, Leopold Franzens University of Innsbruck, Austria; Department of Psychiatry, Borsod County Hospital, Miskolc, Department of Psychology, Kossuth Lajos University of Debrecen and Department of Obstetrics and Gynecology, University of Debrecen Medical School, Hungary; Department of Psychotherapy & Psychosomatic Medicine, University of Leipzig, Germany
W. Söllner
Affiliation:
Departments of Pediatrics and Medical Psychology & Psychotherapy, Leopold Franzens University of Innsbruck, Austria; Department of Psychiatry, Borsod County Hospital, Miskolc, Department of Psychology, Kossuth Lajos University of Debrecen and Department of Obstetrics and Gynecology, University of Debrecen Medical School, Hungary; Department of Psychotherapy & Psychosomatic Medicine, University of Leipzig, Germany
G. Plöttner
Affiliation:
Departments of Pediatrics and Medical Psychology & Psychotherapy, Leopold Franzens University of Innsbruck, Austria; Department of Psychiatry, Borsod County Hospital, Miskolc, Department of Psychology, Kossuth Lajos University of Debrecen and Department of Obstetrics and Gynecology, University of Debrecen Medical School, Hungary; Department of Psychotherapy & Psychosomatic Medicine, University of Leipzig, Germany
*
1Address for correspondence: Dr Günther Rathner, Leopold Franzens University of Innsbruck, Department of Pediatrics, Eating Disorders Unit, Anichstrasse 35, A-6020 Innsbruck, Austria.
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Synopsis

The prevalence of culture-bound syndromes such as eating disorders in the countries of Central and Eastern Europe is unclear and comparative epidemiological studies are lacking. Before the political changes in 1989 we therefore investigated eating disorders, eating attitudes and psychological health in two Eastern European countries and in one Western democracy. A total of 1225 female and male medical students in Hungary, the German Democratic Republic (GDR) and Austria were surveyed. The instruments included the Eating Disorder Inventory and the GHQ. The prevalence of eating disorders was calculated on the basis of simulated DSM-III-R diagnosis. In females, bulimia nervosa prevalence rates of 0·6% (95% CI 0·02, 3·46), 1% (0·2, 2·95) and 0% (0, 2·07) were calculated for Austria, Hungary and the GDR, respectively. For subclinical bulimia nervosa, the rate for Hungary (3·8%; 1·95, 6·72) was twice as high as for Austria (1·9%; 0·39, 5·5) and the GDR (1·7%; 0·36, 4·88). Hungarian subjects indicated more psychiatric ‘caseness’ than their GDR or Austrian counterparts. We conclude that eating disorders represented at least as common a problem in Eastern as Western Europe before the changes in political organization. This may be due to an identification process with Western values. A further increase of eating disorders in these countries induced by the recent changes may be possible.

Type
Original Articles
Information
Psychological Medicine , Volume 25 , Issue 5 , September 1995 , pp. 1027 - 1035
Copyright
Copyright © Cambridge University Press 1995

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References

Beglin, S. J. & Fairburn, C. G. (1992). Women who choose not to participate in surveys on eating disorders. International Journal of Eating Disorders 12, 113–116.3.0.CO;2-W>CrossRefGoogle Scholar
Diem, K. (1968). Documenta Geigy: Wissenschaftliche Tabellen, 7th edn, pp. 99–103. Geigy: Basel.Google Scholar
Di Nicoia, V. F. (1990). Anorexia multiforma: self-starvation in historical and cultural context. Part II. Anorexia nervosa as a culture-reactive syndrome. Transcultural Psychiatric Research Review 27, 245–286.Google Scholar
Dolan, B. (1991). Cross-cultural aspects of anorexia nervosa and bulimia: a review. International Journal of Eating Disorders 10, 67–79.3.0.CO;2-N>CrossRefGoogle Scholar
Faltus, F. (1986). Anorexia nervosa in Czechoslovakia. International Journal of Eating Disorders 5, 581–585.3.0.CO;2-#>CrossRefGoogle Scholar
Fichter, M. M. & Keeser, W. (1980). Das Anorexia nervosa-Inventar zur Selbstbeurteilung (ANIS). Archiv Für Psychiatrie und Nervenkrankheiten 228, 67–89.Google Scholar
Fichter, M. M., Wegerer, S., Sourdi, L., Sourdi, Z. (1983). The epidemiology of anorexia nervosa: a comparison of Greek adolescents living in Germany and Greek adolescents living in Greece. In Anorexia Nervosa: Recent Developments in Research (ed. Darby, P. L., Garfinkel, P. E., Garner, D. M. and Coscina, D. V.), pp. 95–105. Liss: New York.Google Scholar
Fichter, M. M., Elton, M., Sourdi, L., Weyerer, S. & Koptagel-Ilal, G. (1988). Anorexia nervosa in Greek and Turkish adolescents. European Archives of Psychiatry and Neurological Sciences 237, 200–208.CrossRefGoogle ScholarPubMed
Flaherty, J. A., Gaviria, F. M., Pathak, D., Mitchell, T., Wintrob, R., Richman, J. A. & Birz, S. (1988). Developing instruments for cross-cultural psychiatric research. Journal of Nervous and Mental Disease 176, 257–263.CrossRefGoogle ScholarPubMed
Garner, D. M. (1991). Eating Disorder Inventory – 2. Professional Manual. Psychological Assessment Resources: Odessa.Google Scholar
Garner, D. M. & Olmsted, M. P. (1984). Manual for Eating Disorder Inventory (EDI). Psychological Assessment Resources: Odessa.Google Scholar
Goldberg, D. P. & Hillier, V. F. (1979). A scaled version of the General Health Questionnaire. Psychological Medicine 9, 139–145.CrossRefGoogle ScholarPubMed
Goldberg, D. P. & Williams, P. (1988). A User's Guide to the General Health Questionnaire. NFER-Nelson: Windsor.Google Scholar
Irvine, S. H. & Carroll, W. K. (1980). Testing and assessment across cultures: issues in methodology and theory. In Handbook of Cross-Cultural Psychology, vol. 2, (ed. Triandis, H. C. and Berry, J. W.), pp. 181–244. Allyn and Bacon: Boston.Google Scholar
Johnson-Sabine, E., Wood, K., Patton, G., Mann, A. & Wakeling, A. (1988). Abnormal eating attitudes in London schoolgirls – a prospective epidemiological study: factors associated with abnormal response on screening questionnaires. Psychological Medicine 18, 615–622.CrossRefGoogle ScholarPubMed
Kendler, K. S., MacLean, C., Neale, M., Kessler, R., Heath, A. & Eaves, L. (1991). The genetic epidemiology of bulimia nervosa. American Journal of Psychiatry 148, 1627–1637.Google Scholar
King, M. (1989). Eating Disorders in a General Practice Population. Prevalence, Characteristics and Follow-up at 12 to 18 months. Psychological Medicine Monograph Supplement 14. Cambridge University Press: Cambridge.Google Scholar
King, M. & Bhugra, D. (1989). Eating disorders: lessons from a cross-cultural study. Psychological Medicine 19, 955–958.Google Scholar
Korkina, M. V., Tsyvilko, M. A., Marilov, V. V. & Kareva, M. A. (1992). Anorexia nervosa as manifested in Russia. International Journal of Psychosomatics 39, 35–40.Google ScholarPubMed
Krch, F. D. (1991). Épidémiologie des troubles des conduits alimentaires en Tchécoslovaquie. Neuropsychiatrie de l' Enfance 39, 311–322.Google Scholar
Mumford, D. M., Whitehouse, A. M. & Platts, M. (1991). Socio-cultural correlates of eating disorders among Asian schoolgirls in Bradford. British Journal of Psychiatry 158, 222–228.CrossRefGoogle Scholar
Nasser, M. (1986). Comparative study of the prevalence of abnormal eating attitudes among Arab female students of both London and Cairo universities. Psychological Medicine 16, 621–625.CrossRefGoogle ScholarPubMed
Nasser, M. (1988). Eating disorders: the cultural dimension. Social Psychiatry and Psychiatric Epidemiology 23, 184–187.CrossRefGoogle ScholarPubMed
Neumärker, U., Dudeck, U., Vollrath, M., Neumärker, K. J. & Steinhausen, H. C. (1992). Eating attitudes among adolescent anorexia nervosa patients and normal subjects in former East and Wester Berlin. International Journal of Eating Disorders 12, 281–289.Google Scholar
Norring, C. & Sohlberg, S. (1988). Eating Disorder Inventory in Sweden: description, cross-cultural comparison, and clinical utility. Acta Psychiatrica Scandinavica 78, 567–575.CrossRefGoogle ScholarPubMed
Pate, J. E., Pumariega, A. J., Hester, C. & Garner, D. M. (1992). Cross-cultural patterns in eating disorders: a review. Journal of the American Academy of Child and Adolescent Psychiatry 31, 802–809.Google Scholar
Patton, G., Johnson-Sabine, E., Wood, K., Mann, A. & Wakeling, A. (1990). Abnormal eating attitudes in London schoolgirls – a prospective epidemiological study: outcome at twelve months follow-up. Psychological Medicine 20, 383–394.CrossRefGoogle Scholar
Prince, R. (1985). The concept of culture-bound syndromes: anorexia nervosa and brain-fag. Social Sciences and Medicine 21, 197–203.CrossRefGoogle ScholarPubMed
Raich, R. M., Rosen, J. C., Deus, J., Pèrez, O., Requena, A. & Gross, J. (1992). Eating disorder symptoms among adolescents in the United States and Spain: a comparative study. International Journal of Eating Disorders 11, 63–72.Google Scholar
Rathner, G. & Messner, K. (1993). Detection of eating disorders in a small rural town: an epidemiological study. Psychological Medicine 23, 175–184.CrossRefGoogle Scholar
Rathner, G., Bönsch, C., Maurer, G., Walter, M. H. & Söllner, W. (1993). The impact of a ‘guided self-help group’ on bulimic women: a prospective 15 months study of attenders and non-attenders. Journal of Psychosomatic Research 37, 389–396.CrossRefGoogle ScholarPubMed
Rothman, K. J. (1990). No adjustments are needed for multiple comparisons. Epidemiology 1, 43–46.Google Scholar
Steinhausen, H. C. (1984). Transcultural comparison of eating attitudes in young female and anorectic patients. European Archives of Psychiatry and Neurological Sciences 234, 198–201.CrossRefGoogle ScholarPubMed
Steinhausen, H. C., Neumärker, K. J., Vollrath, M., Dudeck, U. & Neumärker, U. (1992). A transcultural comparison of the Eating Disorder Inventory in former East and West Berlin. International Journal of Eating Disorders 12, 407–416.3.0.CO;2-P>CrossRefGoogle Scholar
Swartz, L. (1985). Anorexia nervosa as a culture-bound syndrome. Social Sciences and Medicine 20, 725–730.CrossRefGoogle ScholarPubMed
Szabó, P. & Túry, F. (1991). The prevalence of bulimia nervosa in a Hungarian college and secondary school population. Psychotherapy and Psychosomatics 56, 43–47.Google Scholar
Thiel, A. & Paul, T. (1988). Entwicklung einer deutschsprachigen Version des Eating Disorders Inventory (EDI). Zeitschrift für Differentielle und Diagnostische Psychologie 9, 267–278.Google Scholar
Yager, J., Landsverk, J. & Edelstein, C. E. (1987). A 20-month follow-up study of 628 women with eating disorders. I. Course and severity. American Journal of Psychiatry 144, 1172–1177.Google Scholar
Zok-Jaroszweska, U. (1988). Kliniczne i psychologiczne aspekty anorexia nervosa. Psychoterapia 3, 7–16.Google Scholar