Eating disorders in a multi-ethnic inner-city UK sample: prevalence, comorbidity and service use

Abstract

Purpose

No studies have investigated the prevalence of eating disorders (ED) according to DSM-5 criteria and few have explored their comorbidity and service use in the general population in the UK. We aimed to estimate the prevalence, comorbidity, and service use in individuals with ED in a multi-ethnic inner city sample.

Methods

A total of 1698 individuals (age 16/90) were screened for ED in the first phase of the South East London Community Health Study and 145 were followed up with a diagnostic interview. Data was weighed for survey design and Chi Square tests were used to investigate socio-demographic distribution, comorbidity and service use in participants with ED.

Results

The point prevalence of ED was 4.4 % (Binge Eating Disorder (BED) 3.6 %; Bulimia Nervosa (BN) 0.8 %) and 7.4 % when including sub-threshold diagnoses (Purging Disorder (PD) 0.6 %; Other Specified Feeding and Eating Disorders (OSFED) 2.4 %). No cases of AN were identified. Purging Disorder was the ED with the highest proportion of comorbid disorders. A minority of participants with ED had accessed specialist care services.

Conclusions

ED are common, the comorbidity of ED was in line with previous studies and no ethnic differences were identified. Although PD is not a full diagnosis in DSM-5, we found some evidence of high comorbidity with other disorders, that needs to be replicated using larger samples. Service use was low across ED diagnoses, despite high levels of comorbidity.

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Notes

  1. 1.

    SCOFF questions: Do you make yourself table because you feel uncomfortably full?; Do you worry you have lost control over how much you eat?; Have you recently lost more than one stone in a 3 month period?; Do you believe yourself to be Fat even when other say you are too thin?; Would you say that Food dominates your life?

  2. 2.

    The following procedures were employed to measure participants’ height and weight: Height: participants’ height was measured having them standing with their scapula, buttocks and heels resting against a wall, the neck held in a natural non-stretched position, the heels touching each other, the toe tips form a 45° angle and the head held straight with the inferior orbital border in the same horizontal plane as the external auditive conduct (Frankfort's plane). Weight: a portable scale with a 125 kg maximum capacity and a ± 100 g error margin was used. Individuals were asked to remove shoes and heavy cloths prior to weighing.

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Acknowledgments

The authors are grateful to all SELCoH participants. The authors would also like to thank the SELCoH data manager, Mr. David Pernet, for his invaluable help throughout the project.

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Correspondence to F. Solmi.

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The authors do not report any conflicts of interest.

Financial support

SLH and MH receive salary support from the National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, King’s College London.

This research was supported by the Biomedical Research Nucleus data management and informatics facility at South London and Maudsley NHS Foundation Trust, which is funded by the National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London and a joint infrastructure grant from Guy’s and St Thomas’ Charity and the Maudsley Charity. This research was also funded by a National Institute of Health Research (NIHR) clinician scientist award to Dr N Micali and by a grant received by the British Academy. These funders had no involvement in study design, data collection, analysis or the decision to submit for publication. The authors have no financial involvement (including employment, fees, share ownership) or affiliation with any organisation whose financial interests may be affected by material in the manuscript, or which might potentially bias it. This publication is the work of the authors and Nadia Micali will serve as guarantors for the contents of this paper.

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Solmi, F., Hotopf, M., Hatch, S.L. et al. Eating disorders in a multi-ethnic inner-city UK sample: prevalence, comorbidity and service use. Soc Psychiatry Psychiatr Epidemiol 51, 369–381 (2016). https://doi.org/10.1007/s00127-015-1146-7

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Keywords

  • Eating disorders
  • Comorbidity
  • Prevalence
  • Health services
  • SELCoHII