An Epidemiological Study of Eating Disorders among High School Students in Romania
Krizbai , Tímea, Journal of Cognitive and Behavioral Psychotherapies
The present paper is an epidemiological study of eating disorders in Romania that analyses the prevalence of eating disorders in the Transylvanian high school population. We surveyed 2396 high school adolescents (1140 male, 1256 female), of which 1312 were Hungarian and 1084, Romanian. The prevalence of anorexia nervosa (AN) was 0.6% in the Romanian female sample; no clinical cases of AN were found in the Hungarian female sample. The prevalence of subclinical AN was 0.4% in the Hungarian female sample and 1.9% in the Romanian sample. The prevalence of bulimia nervosa (BN) was 1% in the Hungarian and 1.3% in the Romanian female samples. The prevalence of subclinical BN was 0.8% in the Hungarian female sample and 0.7% in the Romanian female sample. We have not found clinical or subclinical AN in the male sample but the prevalence of BN was 0.2% in the Hungarian male sample. The prevalence of subclinical BN was 0.3% in the Hungarian male sample and 0.5% in the Romanian male sample. Our results draw attention to the presence of eating disorders in Romanian adolescents, possibly due to the internalization of Western values and beauty ideals.
Keywords: eating disorders, epidemiology, Romania, Eastern-Central Europe, high school students
Eating Disorders (ED) have often been considered culture-bound syndromes (Di Nicola, 1990; Prince, 1985; Swartz, 1985). In general, a lower prevalence of ED and disturbed eating attitudes and behaviors has been found among non-Caucasian subjects and among developing countries than in Western industrialized countries (Dolan, 1991). Several studies on this topic have been conducted in Eastern and Central Europe, particularly in Hungary, the former Czechoslovakia, Slovakia, Poland and Bulgaria, indicating that EDs are also wide-spread in this part of Europe.
A study conducted in Hungary by Túry, Szabó and Szendrey (1990) has shown that the prevalence of bulimia nervosa (BN) was 0.8% among males and 1.3% among females. Eating Attitudes Test (EAT) results indicated that 1.5% of the females and 3.6 % of the males had scores above the cutoff point. Tölgyes and Nemessúri (2000) found anorexia attitudes (EAT> 29) in 3% of a high school female sample, but no participants met anorexia nervosa (AN) criteria. The prevalence of BN, based on the Bulimia Investigatory Test (BITE) was 0.6%. Szumska (2001) analyzing a representative sample (n=3615) of young females from Hungary (15-24 years of age) found AN prevalence scores of 0.03% and BN prevalence scores of 0.41% . The prevalence of sub clinical AN was 1.09%, while the prevalence of sub clinical BN was 1.48%. Data from the former Czechoslovakia (Krch & Drábková, 1996) collected in a high school sample (n= 981) records a prevalence of AN of 0.14%, and a prevalence of BN of 5.7% in the female population (no AN or BN was found in males). Researches conducted in Poland (Wlodarczyk-Bisaga, Dolan, McCluskey, & Lacey, 1995; Wlodarczyk- Bisaga & Dolan, 1996) on girls 14-16 years of age, did not identify individuals meeting the criteria for AN or BN, but the prevalence of sub clinical EDs was 2. 34%.
In Bulgaria, Boyadjieva and Steinhausen (1996) studied the prevalence of eating disorders on a small sample, and found a prevalence of 0.94% in the case of AN and of 5.66% in the case of atypical" AN.
Very few epidemiological studies comparing different countries have been conducted. In a study by Fichter, Elton, Sourdi, Weyerer and Koptagel-Ilal (1988) Turkish teenagers from Turkey and Greek teenagers from Greece were compared to Greek teenagers from Western Germany, and a higher prevalence of anorexia nervosa was found in the latter sample, indicating that the social circumstances in Western Germany must have influenced these teenagers who had similar upbringing and cultural background. The only factor that differed between the Greek teenagers from Greece and the Greek teenagers from Western Germany was their social milieu, and it is probable that the increase in ED prevalence has to do with this factor. …