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Am J Psychiatry 1995; 152:1052-1058
Copyright © 1995 by American Psychiatric Association
Bulimia nervosa in a Canadian community sample: prevalence and comparison of subgroups
PE Garfinkel, E Lin, P Goering, C Spegg, DS Goldbloom, S Kennedy, AS Kaplan and DB Woodside
Clarke Institute of Psychiatry, Toronto, Ont., Canada.
OBJECTIVE: Previous epidemiological studies of bulimia nervosa have
generated differing estimates of the incidence and prevalence of the
disorder. These differences are attributable, in part, to varying
definitions of the illness and a range of methodologies. The authors sought
to define the prevalence of bulimia nervosa in a nonclinical community
sample, examine the clinical significance of DSM-III-R threshold criteria,
and examine comorbidity. METHOD: Subjects across Ontario (N = 8,116) were
assessed with a structured interview, the World Health Organization
Composite International Diagnostic Interview, with specific questions added
for bulimia nervosa. Subjects who met DSM- III-R criteria for bulimia
nervosa were compared with those who were missing only the frequency
criterion (two or more binge-eating episodes per week for 3 months).
RESULTS: In this sample, the lifetime prevalence of bulimia nervosa was
1.1% for female subjects and 0.1% for male subjects. The subjects with
full- and partial-syndrome bulimia nervosa showed significant vulnerability
for mood and anxiety disorders. Lifetime rates of alcohol dependence were
high in the full- syndrome group. Rates of parental psychopathologies were
high in both bulimic groups but tended to be higher in the subjects with
full- syndrome bulimia nervosa. Both bulimic groups were significantly more
likely to experience childhood sexual abuse than a normal female comparison
group. CONCLUSIONS: This study confirms other prevalence estimates of
bulimia nervosa and its comorbid diagnoses from studies that were based on
sound methodologies. It also points to the arbitrary aspects of the
frequency of binge eating as a diagnostic threshold criterion for the
disorder.
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