Changing symptomatology in eating disorders.

This exploratory study examined demographic and symptomatological changes in eating-disordered children and adolescents over the last three decades. Medical records of the first 33 consecutive eating disorder admissions to the psychosomatic/psychiatric units of a children's hospital in the 1970s, 1980s, and 1990s were reviewed. Analyses of variance (ANOVAs) and chi square analyses were performed to ascertain changes in demographics, clinical history, height and weight, psychiatric diagnoses, and eating disorder symptoms/signs. In addition, regression analyses were conducted to discern changes in the total number of eating disorder admissions (medical and psychiatric services inclusive) between 1970 and 1990. Results revealed significant symptomatological changes over the three decades. While the majority of somatically based signs have decreased, psychically based symptoms have either remained stable or even increased. Results suggest that newer eating disorder variants (bulimia nervosa and atypical eating disorder) are not replacing the traditional category of anorexia nervosa, rather, eating disorders are becoming more widespread and heterogeneous. Alternative explanations are discussed.