Rathner G, Messner K
Department of Paediatrics, University of Innsbruck, Austria.
Psychol Med. 1993 Feb;23(1):175-84. doi: 10.1017/s0033291700038964.
The occurrence of eating disorders among 517 school girls (11 to 20 years of age) in a small rural Italian town was studied using a three-stage prospective procedure. The screening stage was aimed at defining risk and sub-risk groups. One year later, the risk group (N = 44) and a random sample of the sub-risk (N = 25) and of the screen-negative group (N = 32) were interviewed to detect cases of anorexia/bulimia nervosa. The case registers of four hospitals over a period of 3 years were investigated to detect any additional cases that may have been overlooked in the survey. A minimum point prevalence rate of 1.30% clinical anorexia nervosa, 1.30% sub-clinical anorexia nervosa and 0.87% sub-clinical bulimia nervosa was found for age 15 and above. No case of clinical bulimia nervosa was detected. For age 15 and below no clinical or sub-clinical cases were found. All cases of (sub-)clinical eating disorder initially belonged to the predefined sub-risk and risk groups. Because of the low positive predictive value of any single risk factor, this study shows that early case detection can be improved by using multiple risk indices. In this rural area the prevalence was as high as in metropolitan or urban areas. Urban-rural differences should be assessed in further studies.
采用三阶段前瞻性程序，对意大利一个乡村小镇的517名11至20岁女学生饮食失调症的发生情况进行了研究。筛查阶段旨在确定风险组和亚风险组。一年后，对风险组（N = 44）、亚风险组的一个随机样本（N = 25）和筛查阴性组（N = 32）进行访谈，以检测神经性厌食症/神经性贪食症病例。对四家医院3年期间的病例登记进行了调查，以发现调查中可能被遗漏的任何其他病例。15岁及以上人群中，临床神经性厌食症的最低时点患病率为1.30%，亚临床神经性厌食症为1.30%，亚临床神经性贪食症为0.87%。未检测到临床神经性贪食症病例。15岁及以下未发现临床或亚临床病例。所有（亚）临床饮食失调病例最初都属于预先定义的亚风险组和风险组。由于任何单一风险因素的阳性预测值较低，本研究表明，使用多个风险指数可改善早期病例检测。在这个农村地区，患病率与大都市或城市地区一样高。城乡差异应在进一步研究中评估。
