Eating disorders among healthcare students in three European countries

Abstract

Eating disorders are particularly frequent in young adults, college students included. However eating disorders among European healthcare students are not well known. The objectives were to identify the prevalence of eating disorder (ED) among healthcare students and the associated factors. A cross-sectional study was conducted in France (Rouen, West opal coast and Lille), in Romania (Cluj-Napoca), and in Moldavia (Chisinau). An anonymous self-questionnaire collected age, gender, year of study, depression, anxiety and stress (DASS 21), estimated academic level, smoking and eating disorder (SCOFF test). A clinical algorithm (Expali™) identified the four Broad Categories of ED (hyperphagic, bulimic, anorexic and other ED) derived from DSM-5 with the combine of answers to SCOFF test and body mass index. In total, 1273 healthcare students were included (434 in France, 270 in Moldavia and 569 in Romania). Sex ratio (M:F) was 0.30 and the mean of age 20.2 [standard deviation (SD) = 1.32]. The body mass index were 13.1% of underweight and 14.4% of overweight/obese without difference between the countries (P = 0.34). The prevalence of ED was 19.6% in France, 35.6% in Moldavia and 24.2% in Romania (P < 0.0001). Bulimic disorder was the main ED (42.2%) following by hyperphagic disorders (32.6%), anorexic disorders (10.9%) and other ED (14.3%) with difference between the 3 countries (P = 0.004). After logistic regression, the associated factors with ED were: gender [female AOR = 2.0; 95% CI (1.3–3.1)], year of study [first year AOR = 2.0; 95% CI (1.3–2.9)], depression [AOR = 1.8; 95% CI (1.3–2.5)], anxiety [AOR = 1.6; 95% CI (1.1–2.2)] and country [Moldavia AOR = 2.1; 95% CI (1.4–3.0)]. Our study provides different prevalence of ED among healthcare students in three European countries. The categories of ED were also different according the country. Individual as well as institutional interventions should be targeted university students with the help an easy and quick screening test such as the SCOFF questionnaire, especially in the first year of study.