Cited by 504Eating Disorders and BehaviorsNutrition, Health and Food BehaviorChild Nutrition and Feeding Issues

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Epidemiology and Course of Anorexia Nervosa in the Community

Keski-Rahkonen, Anna, Hoek, Hans W., Susser, Ezra S., Linna, Milla S., Sihvola, Elina, Raevuori, Anu, Bulik, Cynthia M., Kaprio, Jaakko, Rissanen, Aila·2007·American Journal of Psychiatry

DOI 10.1176/appi.ajp.2007.06081388

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Abstract

OBJECTIVE: Most previous studies of the prevalence, incidence, and outcome of anorexia nervosa have been limited to cases detected through the health care system, which may bias our understanding of the disorder's incidence and natural course. The authors sought to describe the onset and outcomes of anorexia nervosa in the general population. METHOD: Lifetime prevalences, incidence rates, and 5-year recovery rates of anorexia nervosa were calculated on the basis of data from 2,881 women from the 1975-1979 birth cohorts of Finnish twins. Women who screened positive for eating disorder symptoms (N=292), their screen-negative female co-twins (N=134), and 210 randomly selected screen-negative women were assessed for lifetime eating disorders by telephone by experienced clinicians. To assess outcomes after clinical recovery and to detect residua of illness, women who had recovered were compared with their unaffected co-twins and healthy unrelated women on multiple outcome measures. RESULTS: The lifetime prevalence of DSM-IV anorexia nervosa was 2.2%, and half of the cases had not been detected in the health care system. The incidence of anorexia nervosa in women between 15 and 19 years of age was 270 per 100,000 person-years. The 5-year clinical recovery rate was 66.8%. Outcomes did not differ between detected and undetected cases. After clinical recovery, the residua of illness steadily receded. By 5 years after clinical recovery, most probands had reached complete or nearly complete psychological recovery and closely resembled their unaffected co-twins and healthy women in weight and most psychological and social measures. CONCLUSIONS: The authors found a substantially higher lifetime prevalence and incidence of anorexia nervosa than reported in previous studies, most of which were based on treated cases. Most women recovered clinically within 5 years, and thereafter usually progressed toward full recovery.

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Authors: Keski-Rahkonen, A., Hoek, H. W., Susser, E. S., Linna, M. S., Sihvola, E., Raevuori, A., Bulik, C. M., Kaprio, J., & Rissanen, A.
ORCID: Hoek, Hans W.
Susser, Ezra S.
Raevuori, Anu
Bulik, Cynthia M.
Kaprio, Jaakko
Venue: American Journal of Psychiatry
Publisher: American Psychiatric Association Publishing
Published: 2007-08
Volume: 164
Issue: 8
Pages: 1259-1265
ISSN: 0002-953X (ISSN-L)
1535-7228
DOI: 10.1176/appi.ajp.2007.06081388
OpenAlex: W2119131488
Cited by: 504
References: 39
Citations by year: 2026: 6 · 2025: 11 · 2024: 18 · 2023: 21 · 2022: 31 · 2021: 35 · 2020: 17 · 2019: 28 · 2018: 25 · 2017: 31 · 2016: 34 · 2015: 47 · 2014: 37 · 2013: 39 · 2012: 31
FWCI: 25.73
Type: journal article
Language: en
Open access: closed
Locations: American Journal of Psychiatry (publishedVersion)
PubMed (publishedVersion)
University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
Funders: National Institute on Alcohol Abuse and Alcoholism (AA12502, R01AA008315, AA08315)
National Institute of Mental Health (MH013043, T32MH013043)
Topics: Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
Keywords: anorexia nervosa, lifetime prevalence, incidence, clinical recovery, undetected cases, eating disorders, women, Finnish Twin Cohort, residual symptoms, psychological recovery
MeSH terms: Adaptation, Psychological, Adult, Anorexia Nervosa, Data Collection, Delivery of Health Care, Diseases in Twins, Female, Finland, Follow-Up Studies, Humans, Prognosis, Surveys and Questionnaires, Social Adjustment, Cohort Studies, Incidence, Prevalence, Women's Health, Outcome Assessment, Health Care, Cost of Illness, Age of Onset, Diagnostic and Statistical Manual of Mental Disorders, Kaplan-Meier Estimate

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Epidemiology and Course of Anorexia Nervosa in the Community

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