ABSTRACT
OBJECTIVE: Affective disorders were studied in two epidemiological studies of children and adolescents in the Canton of Zurich, Switzerland. METHOD: In the Zurich Epidemiological Study of Child and Adolescent Psychopathology Study (ZESCAP) in 1994 a representative cohort of 1964 pupils aged 7-16 years was studied. The Zurich Adolescent Psychology and Psychopathology Study (ZAPPS) included 1089 adolescents aged 15-19 years who were assessed in 1997. A two-stage approach with questionnaire screening of the entire sample in stage 1 and consecutive interviews in stage 2 was used in both studies. Diagnoses according to DSM-III-R were derived from structured parent interviews in the ZESCAP and from both parent and adolescent interviews in the ZAPPS. RESULTS: The total prevalence rate for affective disorders in the ZESCAP was 0.66% (SE 0.25) whereas it was 5.1% based on adolescent interviews and 1.2% based on parent interviews in the ZAPPS. Adolescent girls have significantly higher prevalence rates for affective disorders than boys (9.4 vs. 1.1%). CONCLUSION: These findings are in accordance with various other international epidemiological studies on affective disorders in children and adolescents.
Subject(s)
Mood Disorders/epidemiology , Adolescent , Adolescent Behavior , Child , Child Behavior , Epidemiologic Studies , Female , Humans , Male , Prevalence , Switzerland/epidemiologyABSTRACT
OBJECTIVE: The aim of the study was to assess the treatment and outcome of adolescent eating disorders in an international study including Western and Eastern European clinical and research centres. METHOD: A total of 138 patients with adolescent onset of an eating disorder (primarily anorexia nervosa) were followed-up after a mean interval of 5 years after first admission. RESULTS: On average, the patients had spent 25% of the total follow-up period in either in-patient or out-patient treatment. Half of them required a second hospitalization and a quarter required a third hospitalization for the eating disorder. At follow-up, 68% of the total sample did not have an eating disorder. The prediction of outcome revealed different patterns of risk variables depending on the type of criterion. CONCLUSION: The outcome of adolescent eating disorders is relatively similar across cultures, and better than in patients with later onset of the disorder.
Subject(s)
Cross-Cultural Comparison , Feeding and Eating Disorders/therapy , Adolescent , Adult , Age Factors , Age of Onset , Ambulatory Care , Anorexia Nervosa/diagnosis , Anorexia Nervosa/epidemiology , Anorexia Nervosa/therapy , Berlin/epidemiology , Body Mass Index , Bulgaria/epidemiology , Bulimia/diagnosis , Bulimia/epidemiology , Bulimia/therapy , Feeding and Eating Disorders/diagnosis , Feeding and Eating Disorders/epidemiology , Female , Follow-Up Studies , Hospitalization , Humans , Male , Outcome Assessment, Health Care , Prognosis , Psychotherapy , Romania/epidemiology , Treatment OutcomeABSTRACT
BACKGROUND: A cohort of 60 adolescent eating-disordered patients that was consecutively admitted between 1979 and 1988 to a child and adolescent psychiatric university department in Berlin, Germany was followed up at a mean of 5-0 years and for a second time at a mean of 11.5 years. METHODS: Each patient was personally interviewed and findings dealing with eating disorder symptoms and psychosocial functioning were rated on four-point scales. In addition, the duration of both in-patient and out-patient treatment and the Body Mass Index (BMI) were recorded. RESULTS: Patients were in treatment for a mean of 33 % of the initial 5-year follow-up period, but this has dropped to a mean of 17% of the entire 11-year follow-up period. No predictors of treatment duration were found. The mortality rate was 8.3% at the second follow-up. The distribution of abnormal BMIs ( < 17.5) reflected a trend of improvement with increasing duration of follow-up. In comparison to the 5-year follow-up, fewer patients suffered from symptoms of the full clinical picture of an eating disorder at the 11-year follow-up. Among the surviving patients 80% recovered during the long-term course. There were few specific predictors of three different outcome criteria. CONCLUSION: This outcome study of adolescent eating disorders provides further evidence that the long-term course of the disorders in terms of the eating pathology is better than can be expected after a few years. Very little can be said with regard to individual prognosis.
Subject(s)
Anorexia Nervosa/therapy , Bulimia/therapy , Patient Admission , Adolescent , Adult , Anorexia Nervosa/diagnosis , Anorexia Nervosa/mortality , Body Mass Index , Bulimia/diagnosis , Child , Female , Follow-Up Studies , Hospitals, University , Humans , Outcome Assessment, Health Care , Psychiatric Department, Hospital , Survival RateABSTRACT
In an epidemiological sample of children aged 6 to 17 a total of 1964 parents responded to the Child Behavior Check List (CBCL). A subgroup of 399 parents were interviewed with the Diagnostic Interview Schedule for Children (DISC). The mean syndrome scale scores in the various sex/age groups were in the lower range of several international studies using the CBCL. Effect analyses revealed sex to be more important than nationality (indigenous vs. immigrant) and age. All effects had to be considered as being small. Convergence between syndrome scales of the CBCL and interview-derived DSM-III-R diagnoses was good for three major groups of disorders.
