Anorexia nervosa and religious ambivalence in a developing country

The aim of this study is to report the first case of the primary nuclear form of anorexia nervosa in Trinidad and the West Indies in an 18 year old female Islamic student attending a Roman Catholic Convent. Ambivalent values due to her early development in a strict Muslim home with Catholic influence and contemporaneous exposure to a western society are explored. The dynamics of family interaction in a dual religious home are investigated. Similarities are noted from reports from western countries that link ritualistic fasting to the month of Ramadan. The influence of the Roman Catholic period of fast, Lent and the dynamics of family interaction are discussed. We wish to propose religious ambivalence as an etiological factor in anorexia nervosa in a developing country.

Presence of Anorexia Nervosa and Bulimia Nervosa in Jamaica

We could find no previous data describing the extent to which eating disorders are a public health problem in Jamaica, and so we carried out two exercises to assess this. We investigated the number of cases of anorexia nervosa (AN) and bulimia nervosa (BN) presenting at the University Hospital of the West Indies (UHWI) between 1985 and 1988, using case records, and carried out a survey among health professionals (psychiatrists, clinical psychologists, paediatricians and nutritionists/dietitians) to determine the number of patients with eating disorders seen by them between 1996 and 1998. We also examined the diagnostic criteria used and correlates of eating disorders. Only two cases of AN were treated at UHWI. Eleven cases each of AN and BN (two males) had presented to the health professionals surveyed, chiefly the psychiatrists. The AN patients ranged in age from 14 to 28 years (mean 20.9 years), and the BN patients from 11 to 35 years (mean 22.2 years). Eating disorders were reported primarily among urban dwellers (76 percent), and half of the cases were among students. Limiting food intake, excessive exercise and vomiting were the most frequently used metdods of weight control. Nine eating disorder patients (41 percent) were also diagnosed with depression, and five (23 percent) patients reported previous emotional trauma. The occurrence of eating disorders in Jamaica appears to be very low. (AU)

Two eating disorders in Jamaica

OBJECTIVES: The aims were to assess the public health importance of anorexia nervosa (AN) and bulimina nervosa (BN) in Jamaica, the diagnostic criteria used and their correlates. METHODS: Information was collected from hospital records and from a survey of health professionals. Hospital records from the University Hospital of the West Indies (UHWI) from 1985 to 1998 were searched and all cases that included a diagnosis An or Bn were noted. A questionnaire was given to psychiatrists, clinical psychologists, paediatricians and nutritionists/dietitians requesting information of all An or Bn cases seen between 1996 and 1998, including gender, age, residence, weight, height, occupation, martial status, educational attainment and weight control activity. RESULTS: Only two cases of An were admitted to UHWI during the period studied. Eleven cases of An and 11 cases of BN (only two males) were seen by the health professionals (primarily psychiatrists). DSM-IV was specified as the diagnostic criterion used by the psychiatrists. The mean age of the anorexic patients was 20.9 years (range 14-28 years) and of the bulimic patients was 22.2 years (range 11-35 years). Cases occurred primarily among urban dwellers (76 percent) and 50 percent of the cases were among students. Limiting food intake, excessive exercise and vomiting were the most frequently used methods of weight control. Nine eating disorder patients (40.9 percent) were also diagnosed with depression and 5 (22 percent) patients reported previous emotional trauma. CONCLUSION: The reported incidence of the eating disorders is very low, but the characteristics of the patients seen were similar those in industrialised countries.(Au)

Abnormal eating attitudes and behaviours in two ethnic groups from a female British urban population

African-Caribbean (N=136) and White British (N=192) female family planning clinic attenders were administered the Bulimic Investigatory Test, Edinburgh (BITE) and the General Health Questionnaire (GHQ-28). A proportion of the participants were subsequently interviewed. The African-Caribbeans were found to have both significantly more disordered eating attitudes and a significantly higher level of abnormal eating behaviour than the White British. Although the African-Caribbean group had a significantly higher mean Body Mass Index this did not mediate the difference in levels of eating attitudes. When compared with the White British group more African-Caribbean women reported feelings of failure, guilt, abnormality and self consciousness concerning their eating habits. The results indicate that eating problems may be highly prevalent in this ethnic minority population and suggest that there may be differences in the nature of eating disorder psychopathology between ethnic groups. (AU)

Anorexia nervosa in Barbados - abstract

Anorexia nervosa has been reported with increasing regularity in the more developed countries but very little has been published in this region. The purpose of this study is: 1) To find out the prevalence of anorexia nervosa in the island of Barbados and 2) To develop theories to explain the low prevalence. The records at the general and psychiatric hospitals were used in the search for the number of admissions with the diagnosis of anorexia nervosa over the past 17 years. All the consultant paediatricians and psychiatrists on the island were involved in further case finding from their private practices. General practitioners with a preferance for adolescent medicine were also consulted. The results show that anorexia nervosa is very uncommon in the island of Barbados and this seems to be also true for the other Caribbean islands. When it occurs, the family characteristics are similar to those of the more developed western societies. Anorexia nervosa seems even more uncommon in the lower socio-economic group. Young females in the Caribbean under psychological pressures seldom choose food refusal as the method of expression. They tend to have episodes of hysterical outbursts and conversion reactions. It is logical to expect an increase in prevalence over the next decade due to economic development and the strong influences of television on our youth (AU)