Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-24T23:43:11.409Z Has data issue: false hasContentIssue false

Prevalence of three bulimia syndromes in the general population

Published online by Cambridge University Press:  09 July 2009

John A. Bushnell*
Affiliation:
Departments of Community Health and General Practice, Psychological Medicine, Christchurch School of Medicine, University of Otago, Christchurch, New Zealand
J. Elisabeth Wells
Affiliation:
Departments of Community Health and General Practice, Psychological Medicine, Christchurch School of Medicine, University of Otago, Christchurch, New Zealand
Andrew R. Hornblow
Affiliation:
Departments of Community Health and General Practice, Psychological Medicine, Christchurch School of Medicine, University of Otago, Christchurch, New Zealand
Mark A. Oakley-Browne
Affiliation:
Departments of Community Health and General Practice, Psychological Medicine, Christchurch School of Medicine, University of Otago, Christchurch, New Zealand
Peter Joyce
Affiliation:
Departments of Community Health and General Practice, Psychological Medicine, Christchurch School of Medicine, University of Otago, Christchurch, New Zealand
*
1Address for correspondence: John Bushnell, Department of Community Health and General Practice, Christchurch School of Medicine, University of Otago, PO Box 4345, Christchurch, New Zealand.

Synopsis

Prevalence of bulimia was estimated from a cross-sectional general population survey of 1498 adults, using the Diagnostic Interview Schedule (DIS) administered by trained lay interviewers. Lifetime prevalence of the DSM-III syndrome in adults aged 18–64 was 1·0% and this was concentrated in young women: in women aged 18–44 lifetime prevalence was 2·6%, and 1·0% currently had the disorder. Based on clinicians' reinterviews of random respondents and identified and marginal cases, the prevalence of current disorder using criteria for draft DSM-III-R bulimia was 0·5%, for DSM-III it was 0·2%, and for Russell's Criteria bulimia nervosa 0·0%. A strong cohort effect was found, with higher lifetime prevalence among younger women, which is consistent with a growing incidence of the disorder among young women in recent years. Although elements of the syndromes were so common as to suggest that dysfunctional attitudes to eating and disturbed behaviour surrounding eating are widespread, there was little evidence of the bulimia syndrome having become an epidemic on the scale suggested by early reports.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1990

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abraham, S. R. & Beumont, P. J. V. (1982). How patients describe bulimia or binge eating. Psychological Medicine 12, 625635.CrossRefGoogle ScholarPubMed
American Psychiatric Association (1980). Diagnostic and Statistical Manual of Mental Disorders (3rd edition). American Psychiatric Association Press: Washington, DC.Google Scholar
American Psychiatric Association (1985) DSM-IIIR In Development. American Psychiatric Association Press: Washington, DC.Google Scholar
Ben-Tovim, D. I., Subbiah, N., Scheutz, B. & Morton, J. (1989). Bulimia: symptoms and syndromes in an urban population. Australian and New Zealand Journal of Psychiatry 23, 7380.CrossRefGoogle Scholar
Bland, R. C., Newman, S. C., & Orn, H. (eds) (1988). Epidemiology of psychiatric disorders in Edmonton. Acta Psychiatrica Scandinavica 77, Suppl. No. 338.Google Scholar
Cooper, P. J. & Fairburn, C. G. (1983). Binge eating and self-induced vomiting in the community: a preliminary study. British Journal of Psychiatry 142, 139144.CrossRefGoogle ScholarPubMed
Cooper, P. J., Charnock, D. & Taylor, M. J. (1987). The prevalence of bulimia nervosa: a replication study. British journal of Psychiatry 151, 684686.CrossRefGoogle ScholarPubMed
Copeland, J. (1981). What is a case? A case for what? In What is a case? The Problem of Definition in Psychiatric Community Surveys (ed. Wing, J. K., Bebbington, P. and Robins, L.), pp. 911. Grant McIntyre: London.Google Scholar
Crowther, J. H., Post, G. & Zaynor, L. (1985). The prevalence of bulimia and binge eating in adolescent girls. International Journal of Eating Disorders 4, 2942.3.0.CO;2-H>CrossRefGoogle Scholar
Diem, K. (ed.) (1962). Documenta Geigy: Scientific Tables (6th edn). Geigy. Basle, Switzerland.Google Scholar
Dixon, W. J. (ed) (1985). BMDP Statistical Software. University of California Press: Berkeley.Google Scholar
Drenowski, A., Yee, D. K. & Krahn, D. D. (1988). Bulimia in college women: incidence and recovery rates. American Journal of Psychiatry 145, 753755.Google Scholar
Fairburn, C. G. & Cooper, P. J. (1982). Self induced vomiting and bulimia nervosa: an undetected problem. British Medical Journal 284, 11531155.CrossRefGoogle ScholarPubMed
Fairburn, C. G. & Cooper, P. J. (1984). Binge eating, self induced vomiting and laxative abuse: a community study. Psychological Medicine 14, 401410.CrossRefGoogle ScholarPubMed
Garner, D., Olmsted, M. & Garfinkel, P. (1983 a). Does anorexia nervosa occur on a continuum? International Journal of Eating Disorders 78, 1120.Google Scholar
Garner, D., Olmsted, M. & Polivy, J. (1983 b). Development and validation of a multidimensional Eating Disorder Inventory for anorexia nervosa and bulimia. International Journal of Eating Disorders 78, 8995.Google Scholar
Gray, J. & Ford, K. (1985). Incidence of bulimia in a college sample. International Journal of Eating Disorders 4, 210210.Google Scholar
Halmi, K. A., Falk, J. R. & Schwartz, E. (1981). Binge eating and vomiting: a survey of a college population. Psychological Medicine 11, 697706.CrossRefGoogle ScholarPubMed
Hart, K. J. & Ollendick, T. H. (1936). Prevalence of bulimia in working and university women. American Journal of Psychiatry 142, 851854.Google Scholar
Helzer, J. E., Robins, L. N., McEvoy, L. T., Spilznagel, E. L., Stoltzman, R. K., Farmer, A. & Brockington, I. F. (1985). A comparison of clinical and Diagnostic Interview Schedule diagnoses: physician re-examination of lay-interviewed cases in the general population. Archives of General Psychiatry 42, 657666.CrossRefGoogle Scholar
Johnson, C. L., Stuckey, M. K., Lewis, L. D. & Schwartz, D. M. (1982). Bulimia: a descriptive survey of 316 cases. International Journal of Eating Disorders 2, 318.Google Scholar
Johnson, C., Lewis, C., Love, S., Lewis, S. & Stuckey, M. (1984). Incidence and correlates of bulimic behaviour in a female high-school population. Journal of Youth and Adolescence 13, 1526.CrossRefGoogle Scholar
Karno, M., Hough, R. L., Burnam, A., Escobar, J. I., Timbers, D. M., Santana, F. & Boyd, J. H. (1987). Lifetime prevalence of specific psychiatric disorders among Mexican Americans and non-Hispanic whites in Los Angeles. Archives of General Psychiatry 44, 695701.CrossRefGoogle ScholarPubMed
Kish, L. (1965). Survey Sampling. Wiley: New York.Google Scholar
Nevo, S. (1984). Bulimic symptoms: prevalence and ethnic differences among college women. International Journal of Eating Disorders 4, 151168.Google Scholar
Parker, G. (1987). Are the lifetime prevalence estimates in the ECA study accurate? Psychological Medicine 17, 275282.CrossRefGoogle ScholarPubMed
Pope, H. G., Hudson, T. L. & Yurgelun-Todd, D. (1984). Anorexia nervosa and bulimia among 300 suburban women shoppers. American Journal of Psychiatry 141, 187190.Google ScholarPubMed
Pope, H. G., Hudson, V. I., Yurgelun-Todd, D. & Hudson, M. S. (1985). Prevalence of anorexia nervosa and bulimia in three student populations. International Journal of Eating Disorders 3, 4555.3.0.CO;2-G>CrossRefGoogle Scholar
Pyle, R. L., Halvorson, P. A., Newman, P. A. & Mitchell, J. E. (1986). The increasing prevalence of bulimia in freshmen college students. International Journal of Eating Disorders 5, 631647.3.0.CO;2-E>CrossRefGoogle Scholar
Pyle, R. L., Mitchell, J. E.Eckert, E. D., Halvorson, P. A., Neuman, P. A. & Goff, G. M. (1983). The incidence of bulimia in freshman college students. International Journal of Eating Disorders 2, 7585.Google Scholar
Regier, D. A., Myers, J. K., Kramer, M., Robins, L. N., Blazer, D. G., Hough, R. L., Eaton, W. W. & Locke, B. Z. (1984). The NIMH Epidemiologic Catchment Area Program. Archives of General Psychiatry 41, 934941.CrossRefGoogle ScholarPubMed
Robins, L. N., Helzer, J. E., Croughan, J. & Ratcliff, K. S. (1981). National Institute of Mental Health Diagnostic Interview Schedule: its history, characteristics and validity. Archives of General Psychiatry 38, 381389.CrossRefGoogle ScholarPubMed
Robins, L. N., Helzer, J. E., Weissman, M. M., Orvaschel, H., Gruenberg, E., Burke, J. & Regier, D. A. (1984). Lifetime prevalence of specific psychiatric disorder in three sites. Archives of General Psychiatry 41, 949958.Google Scholar
Romans-Clarkson, S. E., Walton, V. A., Herbison, G. P. & Mullen, P. E. (1988). A study of women who refuse to participate in a community study of psychiatric disorder. Australian and New Zealand Journal of Psychiatry 22, 1929.CrossRefGoogle Scholar
Rothman, K. J. & Boice, J. D. (1982). Epidemiologic Analysis with a Programmable Calculator. Epidemiology Resources: Boston.Google Scholar
Russell, G. (1979). Bulimia nervosa, an ominous variant of anorexia nervosa. Psychological Medicine 9, 429448.CrossRefGoogle ScholarPubMed
Schotte, D. E. & Stunkard, A. J. (1987). Bulimia v. bulimic behaviors on a college campus. Journal of the American Medical Association 258, 12131215.CrossRefGoogle Scholar
Spitznagel, E. L. & Helzer, J. E. (1985). A proposed solution to the base rate problem in the Kappa statistic. Archives of General Psychiatry 42, 725728.CrossRefGoogle Scholar
Stangler, R. S. & Printz, A. M. (1980). DSM-III: psychiatric diagnosis in a university population. American Journal of Psychiatry 137, 937940.Google Scholar
Von Korff, M., Cottler, L., George, L. K., Eaton, W. W., Leaf, P. & Burnam, A. (1985). Non response and non response bias in the ECA Surveys. In Epidemiohgic Field Methods in Psychiatry (ed. Eaton, W. W. and Kessler, L. G.), pp. 8598. Academic Press: London.CrossRefGoogle Scholar
Welch, G. & Hall, A. (in the press). The reliability and discriminant validity of three potential measures of bulimic behaviours. Journal of Psychiatric Research.Google Scholar
Wells, J. E., Bushnell, J. A., Oakley-Browne, M. A., Joyce, P. R. & Hornblow, A. R. (1989). Christchurch Psychiatric Epidemiology Study: methodology and lifetime prevalence for specific psychiatric disorders in Christchurch, New Zealand. Australian and New Zealand Journal of Psychiatry 23, 315326.CrossRefGoogle Scholar
Zuckerman, D. M., Colby, A., Ware, N. C. & Lazerson, J. S. (1986). The prevalence of bulimia among college students. American Journal of Public Health 76, 11351137.CrossRefGoogle ScholarPubMed