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

Abstract

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 21years 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: 3.3years) 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.