Prevalence, comorbidities and outpatient treatment of anorexia and bulimia nervosa in German children and adolescents

  • Charlotte JaiteEmail author
  • Falk Hoffmann
  • Gerd Glaeske
  • Christian J. Bachmann
Original Article



This study aimed at investigating the prevalence, psychiatric comorbidity and outpatient treatment in a sample of German children and adolescents with eating disorders (EDs).


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.


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.


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.


Adolescents Anorexia nervosa Bulimia nervosa Children Statutory health insurance 



We thank the Gmünder Ersatzkasse (GEK) for providing the data and for supporting us in data management. We also thank Ernst Pfeiffer, MD, for comments on the manuscript.

Conflict of interest

CB has received consultant or speaker honoraria from Actelion, Medice, Novartis and Ferring and has acted as investigator in pharmaceutical trials sponsored by Shire. FH, CJ and GG declare that they have no conflicts of interest.


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Copyright information

© Springer International Publishing Switzerland 2013

Authors and Affiliations

  • Charlotte Jaite
    • 1
    Email author
  • Falk Hoffmann
    • 2
  • Gerd Glaeske
    • 2
  • Christian J. Bachmann
    • 3
  1. 1.Department of Child and Adolescent PsychiatryCharité – Universitätsmedizin BerlinBerlinGermany
  2. 2.Division Health Economics, Health Policy and Outcomes Research, Centre for Social Policy ResearchUniversity of BremenBremenGermany
  3. 3.Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Human MedicinePhilipps-University MarburgMarburgGermany

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