Anorexia nervosa in Greek and Turkish adolescents

  • M. M. Fichter
  • M. Elton
  • L. Sourdi
  • S. Weyerer
  • G. Koptagel-Ilal
Article

Summary

Five samples of adolescents were assessed in three countries: (1) 867 Greek pupils in Munich (Germany), (2) 2,700 Greek pupils in Veria (Greece), (3) 567 girls in Ioannina (Greece), (4) 2,783 adolescents in Istanbul (Turkey), and (5) 157 adolescents in Upper Bavaria (Germany). A two-stage procedure was used for samples one, two and four using the Anorexia Nervosa Inventory for Self-rating (ANIS) for screening and a standardized interview (Structured Interview for Anorexia Nervosa and Bulimia) for personal exploration of possible cases and final case identification. Results of all samples were compared. Greek girls in Germany scored higher than Greek boys in Germany and Greek boys and girls in Germany scored lower than Greek girls in Veria in the ANIS factors figure consciousness, insufficiency, anancasm, negative effect of meals and bulimia in practically all age groups. The frequency distribution of the ANIS main factor figure consciousness was the same for both Greek samples in Greece, while the Turkish sample and the Greek sample in Munich had significantly lower scores. In the second stage the prevalence rates for anorexia nervosa according to Feighner criteria (modified for the purpose of a field study) were: 1.10% for Greek girls in Munich, 0.41% for Greek girls in Veria and 0.35% for Greeks in Ioannina. Thus, while Greek girls in Germany had lower scores in ANIS factors and other self-ratings (General Health Questionnaire) the actual rate of anorexic syndromes was highest among Greek girls in Munich. Socio-cultural influences and selection factors are discussed.

Key words

Anorexia nervosa Epidemiology 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Buhrich N (1981) Frequency of presentation of anorexia nervosa in Malaysia. Aust N Z J Psychiatry 15:153–155Google Scholar
  2. Bulik CM (1987) Eating disorders in immigrants: two case reports. Int J Eating Disorders 6:133–141Google Scholar
  3. Button EJ, Whitehouse A (1981) Subclinical anorexia nervosa. Psychol Med 11:509–516Google Scholar
  4. Carter PI, Moss RA (1984) Screening for anorexia and bulimia nervosa in a college population: Problems and limitations. Addict Behav 9:417–419Google Scholar
  5. Castell R, Biener A, Artner K, Beck C (1980) Artikulation und Sprachleistung bei drei- bis siebenjährigen Kindern — Ergebnisse einer Zufallsstichprobe aus der Bevölkerung. Z Kinderpsychol Kinderpsychiatr 29:203–213Google Scholar
  6. Clarke MG, Palmer RL (1983) Eating attitudes and neurotic symptoms in university students. Br J Psychiatr 142:299–304Google Scholar
  7. Crisp AH, Palmer RL, Kalucy RS (1976) In how common is anorexia nervosa? A prevalence study. Br J Psychiatr 128:549–554Google Scholar
  8. Crowther JH, Post G, Zaynor L (1985) The prevalence of bulimia and binge eating in adolescent girls. Int J Eating Disorders, 4:29–42Google Scholar
  9. Eisler I, Szmukler GI (1985) Social class as a confounding variable in the eating attitude test. J Psychiatr Res 19:171–176Google Scholar
  10. Feighner JP, Robins E, Guze SB, Woodruff RA, Winokur G, Munoz R (1972) Diagnostic criteria for use in psychiatric research. Arch Gen Psychiatry 26:57–63Google Scholar
  11. Fichter MM (1985) Magersucht und Bulimia. Springer, Heidelberg Berlin NewYorkGoogle Scholar
  12. Fichter MM, Keeser W (1980) Das Anorexia Nervosa Inventar zur Selbstbeurteilung (ANIS) Eur Arch Psychiatr Neurol Sci 228:67–89Google Scholar
  13. Fichter MM, Elton M, Diallina M, Koptagel-Ilal G, Fthenakis WE, Weyerer S (1988) Mental illness in Greek and Turkish adolescents. Eur Arch Psychiatr Neurol Sci 237:125–134Google Scholar
  14. Fichter M, Weyerer S, Meller I, Eiberger T, Witzke W, Rehm J, Dilling H, Hippius H (in press) Ergebnisse der Oberbayerischen Verlaufsuntersuchung. In: Schmidt MH (ed) Psychiatrische Epidemiologie. VHC Verlag, WeinheimGoogle Scholar
  15. Floru L (1975) Transkulturelle Aspekte der klinisch-psychiatrischen Bilder fremdsprachiger Arbeitnehmer und deren Bedeutung für die nervenärztliche Praxis. Confin Psychiatr 18:193–206Google Scholar
  16. Frieβem DH (1975) Jugendliche aus „Gastarbeiter”-Familien. Prax Kinderpsychol Kinderpsychiatr 24:7–10Google Scholar
  17. Frieβem DH (1978) Psychiatrische und psychosomatische Erkrankungen ausländischer Arbeiter in der BRD. Ein Beitrag zur Psychiatrie der Migration. Psychiatr Neurol Med Psychol(Leipz) 26:78Google Scholar
  18. Goldberg DP (1972) The detection of psychiatric illness by questionnaire. Oxford Univ Press, LondonGoogle Scholar
  19. Goldberg DP, Hillier VF (1979) A scaled version of the General Health Questionnaire. Psychol Med 9:139–145Google Scholar
  20. Gray JJ, Ford K (1985) The incidence of bulimia in a college sample. Int J Eating Disorders 4:201–210Google Scholar
  21. Greenfeld D, Quinlan DM, Harding P, Glass E, Bliss A (1987) Eating behavior in an adolescent population. Intern J Eating Disorders 6:99–111Google Scholar
  22. Halmi KA, Falk JR, Schwartz E (1981) Binge eating and vomiting: a survey of a college population. Psychol Med 11:697–706Google Scholar
  23. Hart KJ, Ollendick TH (1985) Prevalence of bulimia in working and University Women. Am J Psychiatry 142:851–854Google Scholar
  24. Healy K, Conroy RM, Walsh N (1985) The prevalence of binge eating and bulimia in 1,063 college students. J Psychiatr Res 19:161–166Google Scholar
  25. Hill OW (1977) Epidemiologic aspects of anorexia nervosa. Adv Psychosom Med 9:48–62Google Scholar
  26. Hooper MSH, Garner DM (1986) Application of the eating disorders inventory to a sample of black, white and mixed race school girls in Zimbabwe. Int J Eating Disorders 5:161–168Google Scholar
  27. Hsu LKG (1987) Are the eating disorders becoming more common in blacks. Inter J Eating Disorders 6:113–124Google Scholar
  28. Johnson CL, Lewis C, Love S, Stuckey M, Lewis L (1983) Understanding anorexia nervosa and bulimia. Report of the Fourth Ross Conference on Medical Research. Ross Laboratories, Columbus, Ohio, pp 14–20Google Scholar
  29. Johnson C, Lewis C, Love S, Lewis L, Stuckey M (1984) Incidence and correlates of bulimic behavior in a female high school population. J Youth Adol 13:15–26Google Scholar
  30. Kunze D (1977) Somatogramm. Alters-Gröβen-GewichtsBeziehung. Fortschr Med 95:548–549Google Scholar
  31. Mann AH, Wakeling A, Wood K, Monck E, Dobbs R, Szmukler G (1983) Screening for abnormal eating attitudes and psychaitric morbidity in an unselected population of 15-year-old school-girls. Psychol Med 13:573–580Google Scholar
  32. Medianos MG, Madianu DC, Stefanis CN (1981) A cross-cultural study on immigration and mental health implications for prevention. Neurol Psychiatr (Bucur) 4:71–79Google Scholar
  33. Metropolitan Life Insurance Co (1959) New weight standards for men and women. Stat Bull Metrop Insur Co 40:1–4Google Scholar
  34. Moore H, Kleinig G (1960) Das soziale Selbstbild der Gesellschaftsschichten in Deutschland. Kölner Soziol und Soz Psychol 12:86–119Google Scholar
  35. Morgan HG, Sylvester DHG (1974) Epidemiologic aspects of anorexia nervosa. Adv Psychosom Med 9:48–62Google Scholar
  36. Müller R-HM (1975) “Gastarbeiter”-Fremdarbeitsmigration und gesundheitliche Probleme: Eine Übersicht. Ther Umschau Revue 32:542–546Google Scholar
  37. Nasser M (1986) Comparative study of the prevalence of abnormal eating attitudes among Arab female students of both London and Cairo Universities. Psychol Med 16:621–625Google Scholar
  38. Nero S (1985) Bulimic Symptoms: Prevalence and Ethnic Differences among College Women. Int J Eating Disorders 4:151–168Google Scholar
  39. Nylander I (1971) The feeling of being fat and dieting in a school population. An epidemiologic interview investigation. Acta Socio-med Scand 1:17–26Google Scholar
  40. Oppler M (1956) Culture psychiatry and human values. C. Thomas, Springfield, IllGoogle Scholar
  41. Pope HG Jr, Hudson JI, Yurgelun-Todd D, Hudson MS (1984) Prevalence of anorexia nervosa and bulimia in three student populations. Int J Eating Disorders 3:45–51Google Scholar
  42. Pyle RL, Mitchell JE, Eckert ED, Halvorson PA, Neuman PA, Goff GM (1983) The incidence of bulimia in freshman College students. Int J Eating Disorders 2:75–85Google Scholar
  43. Rathner G (1986) Anorexia nervosa — Erste Ergebnisse einer epidemiologischen Untersuchung bei 11–20jährigen Schülerinnen in Südtirol. Paper presented at the 10th Annual Meeting of the Austrian Child Psychiatrists, 17.–19.1.1986, ViennaGoogle Scholar
  44. Schleimer K (1983) Dieting in teenage schoolgirls. A longitudinal prospective study. Acta Paediatr Scand 312:102–111Google Scholar
  45. Szmukler GI (1983) Weight and food preoccupation in population of english schoolgirls. In: Understanding anorexia nervosa and bulimia. Reprint of the 4th Ross Conference on Medical Research. Ross Laboratories, Columbus, OhioGoogle Scholar
  46. Treiman DJ (1975) Problems of concept and measurement in the comparative study of occupational mobility. Soc Sci Res 4:183–230Google Scholar

Copyright information

© Springer-Verlag 1988

Authors and Affiliations

  • M. M. Fichter
    • 1
    • 2
  • M. Elton
    • 1
    • 2
  • L. Sourdi
    • 1
    • 2
  • S. Weyerer
    • 1
    • 2
  • G. Koptagel-Ilal
    • 1
    • 2
  1. 1.Psychiatrische Klinik und PoliklinikPsychiatrische Klinik der Universität MünchenMünchen 2
  2. 2.Psychosomatische Klinik RoseneckPrienGermany

Personalised recommendations