Eating disorders in a national sample of hospitalized female and male veterans: detection rates and psychiatric comorbidity.

OBJECTIVE Using a national sample of hospitalized female and male veterans, this study examined the point prevalence of detected cases of eating disorders and explored psychiatric comorbidity in cases with an eating disorder. METHODS Prevalence rates were determined by reviewing the discharge diagnoses of 24,041 women and 466,590 men hospitalized in Veteran Affairs medical centers during fiscal year 1996. Comorbidity was examined by individually matching eating disorder cases (N = 161) with patients without an eating disorder, using sex, race, and age as matching variables. RESULTS On the basis of routine clinical diagnosis, 0.30% of the female veterans and 0.02% of the male veterans were diagnosed with a current ICD-9-CM eating disorder. Women with eating disorders had significantly elevated rates of comorbid substance, mood, anxiety (particularly posttraumatic stress disorder [PTSD]), adjustment, and personality (particularly borderline personality disorder [BPD]) disorders. Men with eating disorders were found to have high rates of comorbid organic mental, schizophrenic/psychotic, substance, and mood disorder. CONCLUSIONS Our study illustrates the value of administrative data sets for the investigation of uncommon diseases.

[1]  R. Conley,et al.  Comorbid bulimia nervosa and schizophrenia. , 1997, The International journal of eating disorders.

[2]  S. Wonderlich,et al.  Eating disorders and comorbidity: empirical, conceptual, and clinical implications. , 1997, Psychopharmacology bulletin.

[3]  H Jick,et al.  The Demand for Eating Disorder Care , 1996, British Journal of Psychiatry.

[4]  S. Wonderlich,et al.  Childhood sexual abuse and bulimic behavior in a nationally representative sample. , 1996, American journal of public health.

[5]  C. Shisslak,et al.  Eating disturbances among American minority groups: a review. , 1996, The International journal of eating disorders.

[6]  A S Kaplan,et al.  Should Amenorrhoea be Necessary for the Diagnosis of Anorexia Nervosa? , 1996, British Journal of Psychiatry.

[7]  D S Goldbloom,et al.  Bulimia nervosa in a Canadian community sample: prevalence and comparison of subgroups. , 1995, The American journal of psychiatry.

[8]  G. Waller,et al.  Reported sexual abuse and eating psychopathology: a review of the evidence for a causal link. , 1995, The International journal of eating disorders.

[9]  Eric Fombonne Anorexia Nervosa , 1995, British Journal of Psychiatry.

[10]  M. Marcus,et al.  Eating disorders in women: Current issues and debates. , 1995 .

[11]  K. Kendler,et al.  Anorexia nervosa and anorexic-like syndromes in a population-based female twin sample. , 1995, The American journal of psychiatry.

[12]  M. Andrew,et al.  Anorexia nervosa and schizophrenia , 1994, British Journal of Psychiatry.

[13]  K. Halmi,et al.  Psychiatric comorbidity in patients with eating disorders , 1994, Psychological Medicine.

[14]  C. Fairburn,et al.  Sexual abuse and bulimia nervosa: three integrated case control comparisons. , 1994, The American journal of psychiatry.

[15]  F. Manke,et al.  Personality variables and disorders in anorexia nervosa and bulimia nervosa. , 1994, Journal of abnormal psychology.

[16]  R. Kessler,et al.  Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. , 1994, Archives of general psychiatry.

[17]  H. Hoek,et al.  Review of the epidemiological studies of eating disorders. , 1993 .

[18]  M. Råstam Anorexia nervosa in 51 Swedish adolescents: premorbid problems and comorbidity. , 1992, Journal of the American Academy of Child and Adolescent Psychiatry.

[19]  P. Lavori,et al.  Psychiatric comorbidity in treatment-seeking anorexics and bulimics. , 1992, Journal of the American Academy of Child and Adolescent Psychiatry.

[20]  P. Lavori,et al.  The naturalistic history of Bulimia Nervosa : extraordinarily high rates of chronicity, relapse, recurrence, and psychosocial morbidity , 1992 .

[21]  R. Bland Psychiatric Disorders in America: The Epidemiologic Catchment Area Study , 1992 .

[22]  P J Cooper,et al.  Prevalence of eating disorders in three Cambridge general practices: hidden and conspicuous morbidity. , 1992, The British journal of general practice : the journal of the Royal College of General Practitioners.

[23]  K. Halmi,et al.  Comorbidity of psychiatric diagnoses in anorexia nervosa. , 1991, Archives of general psychiatry.

[24]  C. A. Camargo,et al.  Review of bulimia nervosa in males. , 1991, The American journal of psychiatry.

[25]  H. Hoek,et al.  The incidence and prevalence of anorexia nervosa and bulimia nervosa in primary care , 1991, Psychological Medicine.

[26]  R. Kessler,et al.  The genetic epidemiology of bulimia nervosa. , 1991, The American journal of psychiatry.

[27]  C. Fairburn,et al.  Studies of the epidemiology of bulimia nervosa. , 1990, The American journal of psychiatry.

[28]  Kutcher Sp,et al.  Hidden" eating disorders in Scottish psychiatric inpatients. , 1985 .

[29]  S. Kutcher,et al.  "Hidden" eating disorders in Scottish psychiatric inpatients. , 1985, The American journal of psychiatry.

[30]  M M Weissman,et al.  Lifetime prevalence of specific psychiatric disorders in three sites. , 1984, Archives of general psychiatry.

[31]  W. Grove Statistical Methods for Rates and Proportions, 2nd ed , 1981 .

[32]  R. Michels,et al.  Diagnostic and Statistical Manual of Mental Disorders, 3rd ed , 1981 .