Abstract
Objetivo
Estudiar la prevalencia de trastornos alimentarios en la población adolescente en una zona básica de salud.
Diseño
Observacional, transversal.
Emplazamiento
Tres centros urbanos de enseñanza media de Toledo.
Participantes
Estudiantes de 13–16 años.
Mediciones principales
Se administró la versión validada al castellano del Eating Attitudes Test-40, previa autorización de sus padres, para detectar la presencia de trastornos alimentarios. En los casos positivos, se informó mediante carta a los progenitores.
Resultados
Realizaron el cuestionario 503 estudiantes, lo cual representa más del 95% de los adolescentes de la zona. La puntuación media absoluta obtenida fue de 13,42 puntos (IC, 12,57–14,28), siendo en mujeres de 14,71 puntos y de 11,82 en varones. Según los grupos de edad, la puntuación media para 13, 14, 15 y 16 años fue de 14,05, 13,85, 13,08 y 12,60 puntos, respectivamente. Presentaron 3 20 puntos (sensibilidad, 91%; especificidad, 69,2%) un 16,97% y 3 30 puntos (sensibilidad, 67,9%; especificidad, 85,9%) el 6,79% de la muestra.
Hubo un mayor porcentaje de positividad en mujeres que en varones (χ2 = 22,4; p < 0,001). No se encontraron diferencias estadísticamente significativas en relación al grupo de edad (χ 2 = 3,4; p > 0,05).
Conclusiones
Existe una alta prevalencia de trastornos alimentarios en este colectivo, siendo más frecuente en mujeres. Parece justificado realizar intervenciones de prevención de este tipo de problemas así como su búsqueda activa.
Palabras clave: Trastornos del comportamiento alimentario, Adolescentes, EAT
Abstract
Objectives
To study the prevalence of eating disorders among adolescent in a health area.
Design
Cross-sectional descriptive study.
Setting
The primary care centres of secondary education.
Participants
Students with age between 13–16 years.
Measurements
The validation of the Spanish translation of the Eating Attitudes Test-40 was administered to students, previous authorization of their parents. In the positive cases, we reported with a letter to their parents. The date were incorporate to a data base and in order to their treatment tools of analytic and descriptive statistic they were used.
Results
There were 503 valid questionnaires (95% students of the health area). The absolute mean score was 13.42 points (CI, 12.57–14.28), in women 14.71 points and in man 11.82 points.
According to age groups, the mean score for 13, 14.15 and 16 years was 14.05, 13.85, 13.08 and 12.60 points respectively. 16.97% presented ≥ 20 points (sensitivity, 91%; specifity, 69.2%) and 16.97% of the sample ≥ 30 points (sensitivity, 67,9%; specifity, 85.9%).
There were more positive cases in women than men (χ2 = 22.4; p < 0.001). The age variable did not show statistically significant differences (χ 2 = 3.379; p > 0.05). Conclusions
There is a high prevalence of eating disorders among secondary students, being more frecuently among women. We think it is necessary to make preventive services task in these problems and seek positive cases.
Key words: Eating disorders, Adolescents, EAT
Bibliografía
- 1.Toro J. Anorexia nerviosa y bulimia nerviosa. Formación Médica Continuada en Atención Primaria. 1995;2:68–80. [Google Scholar]
- 2.American Psychiatric Association . Diagnostic and Statistical Manual of Mental Disorders (DSM IV) APA; Washington D.C: 1994. [Google Scholar]
- 3.American Psychiatric Association Practice guideline for eating disorders. Am J Psychiatry. 1993;150:212–228. doi: 10.1176/ajp.150.2.212. [DOI] [PubMed] [Google Scholar]
- 4.Whitaker A., Johnson J., Shaffer D., Rapaport J.L. Uncommon troubler in young people: prevalencia estimates of selected psychiatric disorders in a nonreferred adolescent populations. Arch Gen Psychiatry. 1990;47:487–496. doi: 10.1001/archpsyc.1990.01810170087013. [DOI] [PubMed] [Google Scholar]
- 5.Lucas A.R., Beend C.M., O’Fallen W.M., Kurland L.T. 50 year trends in the incidence of anorexia nervosa in Rochester, Minn: a population based study. Am J Psychiatry. 1991;148:917–922. doi: 10.1176/ajp.148.7.917. [DOI] [PubMed] [Google Scholar]
- 6.Bosch X. Spain tackles eating disorders. BMJ. 1999;318:960. doi: 10.1136/bmj.318.7189.960b. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 7.Patton G.C., Selzer R., Coffey C., Carlin J.B., Wolfe R. Onset of adolescent eating disorders: population based cohort study over 3 years. BMJ. 1999;318:765–768. doi: 10.1136/bmj.318.7186.765. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 8.Sánchez-Planell . Vallejo Ruiloba. Introducción a la psicopatología y la psiquiatría. Salvat; Barcelona: 1991. Trastornos de la alimentación; pp. 276–295. [Google Scholar]
- 9.Morandé G., Casas J. Trastornos de la conducta alimentaria en adolescentes. Anorexia nerviosa, bulimia y cuadros afines. Pediatría Integral. 1997;2:243–260. [Google Scholar]
- 10.Garner D.M., Garfinkel P.E. The Eating Attitudes Test: an index of the symptoms of anorexia nervosa. Psychol Med. 1979;9:273–279. doi: 10.1017/s0033291700030762. [DOI] [PubMed] [Google Scholar]
- 11.Wiliams P., Hand D., Tarnopolsky A. The problem of screening for uncommon disorders. A comment on the Eating Attitudes Test. Psychological Medicine. 1982;12:431–434. doi: 10.1017/s003329170004678x. [DOI] [PubMed] [Google Scholar]
- 12.Mann A.H., Wakeling A., Wood K., Monck E., Dobbs R., Szmukler G. Screening for abnormal eating attitudes and psychiatric morbidity in an unselected population of 15-year-old school-girls. Psychol Med. 1983;13:573–580. doi: 10.1017/s0033291700047991. [DOI] [PubMed] [Google Scholar]
- 13.Nasser M.M. The validity of the Eating Attitudes Test in a non-Western population. Acta Psychiatr Scand. 1986;73:109–110. doi: 10.1111/j.1600-0447.1986.tb02675.x. [DOI] [PubMed] [Google Scholar]
- 14.Rickey L., Williams M.D. Use of the eating attitudes test and disorders inventory in adolescents. J Adolesc Health. 1987;8:266–272. doi: 10.1016/0197-0070(87)90430-x. [DOI] [PubMed] [Google Scholar]
- 15.Castro J., Toro J., Salamero M., Guimera E. The Eating Attitudes Test: validation of the Spanish version. Eval Psicol/Psychol Assess. 1991;7:175–190. [Google Scholar]
- 16.Lázaro J., Toro J., Canalda G., Castro J., Martínez E., Puig J. Variables clínicas, psicológicas y biológicas en un grupo de 108 pacientes adolescentes con anorexia nerviosa. Med Clin (Barc) 1996;107:169–174. [PubMed] [Google Scholar]
- 17.Martínez A., Menéndez D., Sánchez M.J., Seoane M., Suárez P. Conductas anoréxicas en la población de estudiantes de secundaria de un área sanitaria. Aten Primaria. 2000;25:313–319. doi: 10.1016/S0212-6567(00)78511-8. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 18.Garner D.M. Patogenia de la anorexia nerviosa. Lancet (ed esp.) 1993;23:280–289. [Google Scholar]
- 19.Toro J., Cervera M., Pérez P. Body shave, publicity and anorexia nervosa. Soc Psychiatry. 1998;23:132–136. doi: 10.1007/BF01788434. [DOI] [PubMed] [Google Scholar]
- 20.Martínez E., Toro J., Salamero M. Influencias socioculturales favorecedoras del adelgazamiento y sintomatología. Rev Psiquiatr Fac Med Barc. 1996;23:125–133. [Google Scholar]
- 21.Halmi K.A., Eckert E., Marchi P., Sampugnaro V., Apple R., Cohen J. Comorbidity of psychiatric diagnosis in anorexia nervosa. Arch Gen Psych. 1991;48:712–718. doi: 10.1001/archpsyc.1991.01810320036006. [DOI] [PubMed] [Google Scholar]
- 22.Terry P.C., Lane A.M., Warren L. Eating attitudes, body shape perceptions and mood of elite rowers. J Sci Med Sport. 1999;2:67–77. doi: 10.1016/s1440-2440(99)80185-6. [DOI] [PubMed] [Google Scholar]
- 23.Lask B. Rewiew of anorexia and bulimia. J Am Acad Child Adolesc Psychiatry. 1999;38:109–110. doi: 10.1097/00004583-199902000-00001. [DOI] [PubMed] [Google Scholar]
- 24.Toro J., Castro J., García M., Pérez P., Cuesta L. Eating attitudes, sociodemographic factors and body shape evaluation in adolescence. Br J Psychol. 1989;62:61–70. doi: 10.1111/j.2044-8341.1989.tb02811.x. [DOI] [PubMed] [Google Scholar]
- 25.Lee S. Anorexia nervosa in males. Aust N Z J Psychiatry. 1994;28:147–148. [PubMed] [Google Scholar]
- 26.Padierna A., Silva M., Horcajo M.J., Vicente M.J., Ponte J., López E. Evolución de la demanda asistencial por trastornos alimentarios en un programa específico (1992–1999) An Psiquiatría. 1999;5:325–328. [Google Scholar]
- 27.Martínez Mallén E., Toro J., Salamero M., Blecua M.J., Zaragoza M. Influencias socioculturales sobre las actitudes y conductas femeninas relacionadas con el cuerpo y la alimentación. Rev Psiquiatría Fac Med Barna. 1993;20:51–65. [Google Scholar]
- 28.Pla C., Toro J. Anorexia nervosa in a Spanish adolescent sample: an 8-year longitudinal study. Acta Psychiatr Scand. 1999;100:441–446. doi: 10.1111/j.1600-0447.1999.tb10894.x. [DOI] [PubMed] [Google Scholar]
- 29.Toro J., Nicolau R., Cervera M., Castro J., Blecua M.J., Zaragoza M. A clinic and phenomenological study of 185 spanish adolescents with anorexia nervosa. Eur Child Adolesc Psychiatry. 1995;4:165–175. doi: 10.1007/BF01980455. [DOI] [PubMed] [Google Scholar]
- 30.Nilsson E.W. Ten-year follow-up of adolescent-onset anorexia nervosa. J Am Acad Child Adolesc Psychiatry. 1999;38:1389–1395. doi: 10.1097/00004583-199911000-00013. [DOI] [PubMed] [Google Scholar]
- 31.PAPPS Actualización-1999. Aten Primaria. 1999;24:9–192. [Google Scholar]
- 32.Eagles J.M., Johnston M.I., Hunter D., Lobban M., Millar H.R. Increasing incidence of anorexia nervosa in the female population of Northeast Scotland. Am J Psychiatriy. 1995;152:1266–1271. doi: 10.1176/ajp.152.9.1266. [DOI] [PubMed] [Google Scholar]
- 33.Pagsberg A.K., Wang A.R. Epidemiology of anorexia nervosa and bulimia nervosa in Bornholm County, Denmark, 1970–1989. Acta Psychiatr Scand. 1994;90:259–265. doi: 10.1111/j.1600-0447.1994.tb01590.x. [DOI] [PubMed] [Google Scholar]
- 34.Menéndez F., Pedreira J.L. Trastornos de la conducta alimentaria en niños y adolescentes. Rev Asoc Esp Neuropsiq. 1999;19:7–22. [Google Scholar]
- 35.Van Hoeken D., Lucas A.R., Hoek H.W. Epidemiology. In: Hoek H.W., Treasure J., Katzman M.A., editors. Neurobiology in the treatment of eating disorders. John Wiley & Sons; Chichester: 1998. pp. 97–126. [Google Scholar]
- 36.Gila A., Castro J., Toro J., Salamero M. Subjective body-image dimensions in normal and anorexic adolescents. Br J Med Psychol. 1998;71(Pt 2):175–184. doi: 10.1111/j.2044-8341.1998.tb01378.x. [DOI] [PubMed] [Google Scholar]
- 37.Instituto Nacional de la Salud . Protocolo de trastornos del comportamiento alimentario. Instituto Nacional de la Salud; Madrid: 1995. pp. 11–12. [Google Scholar]
- 38.Matsunaga H. Clinical characteristics in patients with anorexia nervosa and obsessive-compulsive disorder. Psychol Med. 1999;29:407–414. doi: 10.1017/s003329179800796x. [DOI] [PubMed] [Google Scholar]
- 39.Fukoka Y. What is the most serious complication for patients with anorexia nervosa? Prog Cardiovasc Nurs. 1999;14:75–76. [PubMed] [Google Scholar]
- 40.Cabranes J.A., Gil I., Gómez Candela C., Gual P., Julián R., Ponce de León C. Protocolo de atención a pacientes con trastornos del comportamiento alimentario (TCA) dirigido a médicos de atención primaria. Ministerio de Sanidad y Consumo. Secretaria General Técnica, Centro de Publicaciones; Madrid: 2000. [Google Scholar]