The outcome of adolescent eating disorders: findings from the Victorian Adolescent Health Cohort Study.
The study aimed to ascertain the outcome of adolescent onset eating disorders in a representative cohort of females. The design was a seven wave cohort study conducted over 6 years. 982 female participants from a total sample of 2032 secondary school students initially aged 14-15 years at 44 schools in the state of Victoria Australia. Branched questionnaires (BET) were used for assessing symptoms of eating disorder. A partial syndrome was defined where a subject met two DSM-IV criteria for either anorexia or bulimia nervosa. The revised Clinical Interview Schedule (CIS-R) was used for assessing depression and anxiety, and self-report frequency of use and retrospective diaries for substance use. The mean point prevalence of eating disorders in females between 15-18 years at the partial syndrome level was 2.4 % (1.8-31). At follow-up at the age of 20 years the point prevalence was 3 % (1.9-4.1). In all 8.8 % reported an eating disorder across the six year study period. Eleven percent of those with eating disorder in the teens had persisting disorder at follow-up. In contrast, close to 50 % had high levels of depression and anxiety, a finding that was particularly marked for those with the partial syndrome of bulimia nervosa during the teens. The bulimia group tended to report a higher level of heavy alcohol use at follow-up. Eating disorders at the partial syndrome level are common in young women but most teenage syndromes are brief and self-limiting. The findings are consistent with the partial syndrome of bulimia nervosa being viewed as a variant of affective disorder with different associated behaviours at particular developmental points.
Patton
G C
GC
Centre for Adolescent Health, University of Melbourne, Parkville 3052, Australia.
Coffey
C
C
Sawyer
S M
SM
D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000453:epidemiology; D001007:Anxiety / Q000453:epidemiology; D002032:Bulimia / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology; D001068:Feeding and Eating Disorders / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D015995:Prevalence; D019966:Substance-Related Disorders / Q000453:epidemiology; D013577:Syndrome; D016896:Treatment Outcome; D014739:Victoria / Q000453:epidemiology; D015431:Weight Loss