title: Prevalence, comorbidities and outpatient treatment of anorexia and bulimia nervosa in German children and adolescents.
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).
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Child and Adolescent Psychiatry, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany, charlotte.jaite@charite.de.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Jaite
authors.forename: Falk
authors.initials: F
authors.lastname: Hoffmann
authors.forename: Gerd
authors.initials: G
authors.lastname: Glaeske
authors.forename: Christian J
authors.initials: CJ
authors.lastname: Bachmann
mesh_terms: D000293:Adolescent; D000553:Ambulatory Care; D000856:Anorexia Nervosa / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D001008:Anxiety Disorders / Q000453:epidemiology*; D052018:Bulimia Nervosa / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D002648:Child; D015897:Comorbidity; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D003866:Depressive Disorder / Q000453:epidemiology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D010045:Outpatients; D015995:Prevalence; D013001:Somatoform Disorders / Q000453:epidemiology*; D055815:Young Adult