Prevalence of eating disorders and minor psychiatric morbidity in central Europe before the political changes in 1989: a cross-cultural study.

The prevalence of culture-bound syndromes such as eating disorders in the countries of Central and Eastern Europe is unclear and comparative epidemiological studies are lacking. Before the political changes in 1989 we therefore investigated eating disorders, eating attitudes and psychological health in two Eastern European countries and in one Western democracy. A total of 1225 female and male medical students in Hungary, the German Democratic Republic (GDR) and Austria were surveyed. The instruments included the Eating Disorder Inventory and the GHQ. The prevalence of eating disorders was calculated on the basis of simulated DSM-III-R diagnosis. In females, bulimia nervosa prevalence rates of 0.6% (95% CI 0.02, 3.46), 1% (0.2, 2.95) and 0% (0, 2.07) were calculated for Austria, Hungary and the GDR, respectively. For subclinical bulimia nervosa, the rate for Hungary (3.8%; 1.95, 6.72) was twice as high as for Austria (1.9%; 0.39, 5.5) and the GDR (1.7%; 0.36, 4.88). Hungarian subjects indicated more psychiatric 'caseness' than their GDR or Austrian counterparts. We conclude that eating disorders represented at least as common a problem in Eastern as Western Europe before the changes in political organization. This may be due to an identification process with Western values. A further increase of eating disorders in these countries induced by the recent changes may be possible.