Evaluation of a German version of a brief diagnosis questionnaire of symptoms of orthorexia nervosa in patients with mental disorders (Ortho-10)

  • Sylke AndreasEmail author
  • Kirsten Schedler
  • Holger Schulz
  • Detlev O. Nutzinger
Original Article
Part of the following topical collections:
  1. Orthorexia Nervosa



In recent years, a new term—orthorexia nervosa (ON)—has been introduced in the field of clinical assessment and psychotherapy. Orthorexia nervosa is defined as a fixation on healthy food and a pathological obsession to eat food with more natural, higher quality ingredients. Although instruments to measure ON are available, no study on the psychometric properties of the original developed instrument by Bratman (Orthorexia nervosa: Overcoming the obsession with healthful eating, Broadway Books, New York, 2000) in a large clinical sample exists until now.


The study was conducted in a large clinic in Germany. The study sample consisted of N = 1122 inpatients, 70% were female, and the mean age was 41 years (SD = 14 years). The main diagnoses at the end of treatment were affective disorders (46%), followed by eating disorders (13%), anxiety disorders (10%), and personality disorders (10%). The patients filled out several instruments, like the Ortho-10, the 10-item version of the orthorexia nervosa instrument, and other construct-related, disorder-specific and construct-distant instruments.


The exploratory factor analysis revealed a two-factor structure: an eating disorder-specific factor and an orthorexia-nervosa specific factor. The eating disorder factor showed good convergent and discriminative validity in which patients with eating disorders and those without could correctly be classified. However, the orthorexia-nervosa specific factor revealed no informational gain compared to the eating disorder-specific factor in this clinical sample.


Further investigation is necessary to approach the concept of ON and its sense in clinical samples.

Level of evidence

Level II: evidence obtained from well-designed controlled trials without randomization.


Orthorexia nervosa Screening instrument Psychometric properties Clinical sample 



We would like to thank the patients of the Klinik Bad Bramsted for their willing participation. Finally, we thank the anonymous reviewers for their valuable comments.

Compliance with ethical standards

Informed consent

Informed consent was obtained from all individual participants included in the study.



Conflict of interest

All authors declare that there is no conflict of interest.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study has been approved by the ethic committee of the University of Luebeck, Germany.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2017

Authors and Affiliations

  1. 1.Institute of PsychologyAlpen-Adria-Universität KlagenfurtKlagenfurtAustria
  2. 2.Department of Medical PsychologyUniversity Clinic Hamburg-EppendorfHamburgGermany
  3. 3.Department of PsychologyUniversity of WittenWittenGermany
  4. 4.Medizinisch-Psychosomatische Klinik Bad BramstedtSchön-KlinikenBad BramstedtGermany
  5. 5.Department of Psychosomatic MedicineUniversity of LübeckLübeckGermany

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