Abstract
Background
The community prevalence of eating disorders among Chinese young women may now be similar to their western counterparts.
Aim
To investigate the prevalence of eating disorders (ED) in female university students in Wuhan, China, using a two-stage design.
Method
In stage one, 99.1 % (N = 8,444) of eligible students (N = 8,521) completed the eating disorder inventory-1 (EDI-1) and a survey of relevant anthropomorphic data. A total of 421 women scored above the cut-off for EDE-1, as defined by a set of criteria similar to those of Keski-Rahkonen (Int J Eat Disord 39:754–762, 2006). 257 (61 %) of these case-positive women and a random sample of case-negative women (312 out of 8,023, 4 %) whose scores did not exceed the defined cut-off were interviewed using the eating disorder examination (EDE) and the structured clinical interview for DSM-IV axis I disorders (SCID-I).
Results
On interview with the SCID-I, 79 women were diagnosed with an ED. Among them, 10 had anorexia nervosa (AN), 21 bulimia nervosa (BN), and 48 binge eating disorder (BED) The results showed a prevalence rate of 1.05 % (95 % CI = 0.02–2.08) for AN, 2.98 % (95 % CI = 1.21–4.74) for BN, and 3.53 % (95 % CI = 1.75–5.30) for BED.
Conclusion
The prevalence of ED among female university students in China is now similar to that of their western counterparts, and BED is the most common ED followed by BN and AN similarly.
Similar content being viewed by others
References
Klump KL, Builk CM, Kaye WH, Treasure J, Tyson E (2009) Academy for eating disorders position paper: eating disorders are serious mental illnesses. Int J Eat Disord 42:97–103
Thompson A, Shaw M, Harrison G, Ho D, Gunnell D, Verne J (2004) Patterns of hospital admission for adult psychiatric illness in England: analysis of hospital episode statistics data. Br J Psychiatry 185:334–341
Striegel-Moore RH, DeBar L, Wilson GT, Dickerson J, Rosselli F, Perrin N et al (2008) Health services use in eating disorders. Psychol Med 38:1465–1474
Hudson JI, Hiripi E, Pope Harrison G, Kessler RC Jr (2007) The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biol Psychiatry 61:348–358
Mitchell JE, Crows S (2006) Medical complications of anorexia nervosa and bulimia nervosa. Curr Opin Psychiatry 19:438–443
Sullivan PF (1995) Mortality in anorexia nervosa. Am J Psychiatry 152:1073–1074
Swanson SA, Crow SJ, Grange DL, Swendsen J, Merikangas KR (2011) Prevalence and correlates of eating disorders in adolescents: results from the National Comorbidity Survey Replication Adolescent Supplement. Arch Gen Psychiatry 68:714–723
van Son GE, van Hoeken D, van Furth EF, Donker GA, Hoek HW (2010) Course and outcome of eating disorders in a primary care-based cohort. Int J Eat Disord 43:130–138
Keski-Rahkonen A, Hoek HW, Susser ES, Linna M, Sihvola E, Raevuori A et al (2007) Epidemiology and course of anorexia nervosa in the community. Am J Psychiatry 164:1259–1265
Lee S, Lee AM (2000) Disordered eating in three communities of China: a comparative study of female high school students in Hong Kong, Shenzhen, and rural Hunan. Int J Eat Disord 27:317–327
Lee S, Ng KL, Kwok K, Fung C (2010) The changing profile of eating disorders at a tertiary psychiatric clinic in Hong Kong (1987–2007). Int J Eat Disord 43:307–314
Ackard DM, Fulkerson JA, Neumark-Sztainer D (2007) Prevalence and utility of DSM-IV eating disorder diagnostic criteria among youth. Int J Eat Disord 40:409–417
Gauvin L, Steiger H, Brodeur JM (2009) Eating-disorder symptoms and syndromes in a sample of urban-dwelling Canadian women: contributions toward a population health perspective. Int J Eat Disord 42:158–165
Keski-Rahkonen A, Hoek HW, Linna MS, Raevuori A, Sihvola E, Bulik CM et al (2009) Incidence and outcomes of bulimia nervosa: a nationwide population-based study. Psychol Med 39:823–831
Fu DD, Wang JP, Wang XY, Chen W (2008) Eating disorder of female university students in Beijing and its relation with personality. Chin J Clin Psychol 16:31–33
Van Son GE, Van HD, Bartelds AI, Van Furth EF, Hoek HW (2006) Urbanization and the incidence of eating disorders. Br J Psychiatry 189:562–563
Pavlova B, Uher R, Dragomirecka E, Papezova H (2010) Trends in hospital admissions for eating disorders in a country undergoing a socio-cultural transition, the Czech Republic 1981–2005
Garner DM, Olmsted MP, Polivy J (1983) Development and validation of a multidimensional eating disorder inventory for anorexia and bulimia. Int J Eat Disord 2:15–34
Podar I, Allik J (2009) A cross-cultural comparison of the eating disorder inventory. Int J Eat Disord 42:346–355
Zhang DR, Kong QM (2004) Applicability of EDI-1 in Beijing. Chin Mental Health J 18:48–50
Tachi T, Murakami K, Washizuka T, Ikuta N, Nishizono AM, Miyake Y (2005) Application of the eating disorder examination (EDE) to Japanese patients with eating disorders: reliability and validity of the Japanese version of EDE. Jpn J Psychosom Med 45(5):785–792
Lau LLS, Lee S, Lee E, Wong W (2006) Cross-cultural validity of the eating disorder examination: a study of Chinese outpatients with eating disorders in Hong Kong. Hong Kong J Psychiatry 16:132–136
Lee HY, Lock J (2007) Anorexia nervosa in Asian-American adolescents: do they differ from their non-Asian peers? Int J Eat Disord 40:227–231
Tong J, Shi J, Wang J, Zhang H, Zhang SF, Wu XY et al (2011) Validity and reliability of the Chinese language version of the eating disorder examination (CEDE) in Mainland China: implications for the identity and nosology of the eating disorders. Int J Eat Disord 44:76–80
Keski-Rahkonen A, Sihvola E, Raevuori A, Kaukoranta J, Bulik CM, Hoek HW et al (2006) Reliability of self-reported eating disorders: optimizing population screening. Int J Eat Disord 39:754–762
Fairburn C, Cooper Z (1993) The eating disorder examination. In: Fairburn CG, Wilson GT (eds) Binge eating: nature, assessment, and treatment. Guilford Press, New York, pp 317–360
Berg KC, Peterson CB, Frazier P, Crow SJ (2012) Psychometric evaluation of the eating disorder examination and eating disorder examination-questionnaire: a systematic review of the literature. Int J Eat Disord 45:428–438
Pickles A, Dunn G, Vázquez-Barquero JL (1995) Screening for stratification in two-phase (two-stage) epidemiological surveys. Stat Methods Med Res 4:73–89
Phillips MR, Zhang J, Shi Q, Song Z, Ding Z, Pang S et al (2009) Prevalence, treatment, and associated disability of mental disorders in four provinces in China during 2001–05: an epidemiological survey. Lancet 373:2041–2053
Guo WJ, Tsang A, Li T, Lee S (2011) Psychiatric epidemiological surveys in China 1960–2010: how real is the increase of mental disorders? Curr Opin Psychiatry 24:324–330
Demyttenaere K, Bruffaerts R, Posada-Villa J, Gasquet I, Kovess V, Lepine JP, WHO World Mental Health Survey Consortium et al (2004) Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA 291:2581–2590
Tseng MM, Fang D, Lee MB, Chie WC, Liu JP, Chen WJ (2007) Two-phase survey of eating disorders in gifted dance and non-dance high-school students in Taiwan. Psychol Med 37:1085–1096
Lee S, Lee MTY, Chiu MYL, Kleinman A (2005) Experience of social stigma by people with schizophrenia in Hong Kong. Br J Psychiatry 186:153–157
Hsu LKG, Wan YM, Chang H, Summergrad P, Tsang B, Chen HT (2008) Stigma of depression is more severe among Chinese Americans than Caucasian Americans. Psychiatry 71:210–218
Lee S, Kwok K, Liau C, Leung T (2002) Screening Chinese patients with eating disorders using the eating attitudes test in Hong Kong. Int J Eat Disord 32:91–97
Hoek HW, Hoeken D (2003) Review of the prevalence and incidence of eating disorders. Int J Eat Disord 34:383–396
Jacobi C, Abascal L, Taylor CB (2004) Screening for eating disorders and high-risk behavior: caution. Int J Eat Disord 36:280–295
Acknowledgments
This work has been funded by National Key Technologies R&D Program (National demonstrative study on comprehensive screening, evaluation and intervention for issues of family, marriage and parent–child relation, 2009 BAI77B05) and Human development and mental health in Hubei province key laboratory open project (200902).
Conflict of interest
None.
Author information
Authors and Affiliations
Corresponding author
Additional information
Shaojiang Miao, PHD is a co-first author.
Rights and permissions
About this article
Cite this article
Tong, J., Miao, S., Wang, J. et al. A two-stage epidemiologic study on prevalence of eating disorders in female university students in Wuhan, China. Soc Psychiatry Psychiatr Epidemiol 49, 499–505 (2014). https://doi.org/10.1007/s00127-013-0694-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00127-013-0694-y