Original article Incidence of eating disorders in Navarra (Spain) Francisca Lahortiga-Ramos a, *, Jokin De Irala-Estévez b , Adrián Cano-Prous a , Pilar Gual-García c , Miguel Ángel Martínez-González b , Salvador Cervera-Enguix a a Department of Psychiatry and Medical Psychology, University Clinic, University of Navarra Medical School, Avda. Pío XII, 36. 31008, Pamplona, Spain b Department of Epidemiology and Public Health, University of Navarra Medical School, Pamplona, Spain c Department of Psychology and Psychiatry, International University of Catalonia, Barcelona, Spain Received 26 February 2004; accepted 15 July 2004 Available online 02 November 2004 Abstract Purpose. – To estimate the overall annual incidence and age group distribution of eating disorders in a representative sample of adolescent female residents of Navarra, Spain. Methods. – We studied a representative sample of 2734 adolescent Navarran females between 13 and 22 years of age who were free of any eating disorder at the start of our study. Eighteen months into the study, we visited the established centers and the eating attitudes test (EAT-40) and eating disorder inventory (EDI) Questionnaires were administered to the entire study population. We obtained a final response of 92%.All adolescents whose EAT score was over 21 points and a randomized sample of those who scored 21 or below, were interviewed.Any person meeting the DSM-IV diagnostic criteria for Anorexia Nervosa (AN), Bulimia Nervosa (BN) or eating disorder not otherwise specified (EDNOS) was considered a case. Results. – We detected 90 new cases of eating disorders.Taking into consideration the randomly selected group whose EAT score was 21 points or below, we estimated the overall weighted incidence of eating disorders to be 4.8% (95% CI: 2.8–6.8), after 18 months of observation, in which EDNOS predominated with an incidence of 4.2% (95% CI: 2.0–6.3). The incidence of AN was 0.3% (95% CI: 0.2–0.5), while that of BN was also found to be 0.3% (95% CI: 0.2–0.5). The highest incidence was observed in the group of adolescents between 15 and 16 years of age. Conclusions. – The overall incidence of ED in a cohort of 2509 adolescents after 18 months of follow-up was 4.8% (95% CI: 2.8–6.8), with EDNOS outweighing the other diagnoses. The majority of new cases of eating disorders were diagnosed between ages 15 and 16. © 2004 Elsevier SAS. All rights reserved. Keywords: Eating disorders; Anorexia Nervosa; Bulimia Nervosa; Esting disorders not otherwise specified; Incidence; Eating attitudes test 1. Introduction Among the mental disorders, eating disorders (ED) have gained exceptional importance in recent decades, as evi- denced by the numerous studies related to these diseases. This interest is stimulated by the need to prevent, to early detect and to effectively treat a group of disorders that affect a large population sector. A variety of factors including personality, genetic inheritance, neurobiological alterations and the mass media’s portrayal of thinness as an attractive quality, all play a role. European and North American screening studies for ED have found that between 10% and 25% of adolescents scored above the limit for ED in a variety of questionnaires aimed at detecting ED [1]. In addition, it is estimated that Anorexia Nervosa (AN) and Bulimia Nervosa (BN) affect approximately 1.2 million women in the US [10], occupying the third cause of illness in the young population after obe- sity and asthma [26]. These disorders present a chronic course, an elevated morbidity [25] and a mortality ranging from 6% to 15% [8,17,29]. Discrepancies are observed in data from incidence and prevalence studies on ED conducted over the recent years. This could be due to different methodological problems [9], such as the use of large-scaled psychiatric databases, the low positive predictive value and low validity and transcultural * Corresponding author. E-mail address: flahortiga@unav.es (F. Lahortiga-Ramos). European Psychiatry 20 (2005) 179–185 http://france.elsevier.com/direct/EURPSY/ 0924-9338/$ - see front matter © 2004 Elsevier SAS. All rights reserved. doi:10.1016/j.eurpsy.2004.07.008