Eating problems in Irish children and adolescence - EPICA.

OBJECTIVES: To examine eating concerns in a cohort of Irish adolescents. METHODS: Students from a stratified random sample of post primary schools were screened using the EAT-26, the EDI-III and a study specific questionnaire. RESULTS: A total of 3,031 students (mean age 14.74, range 12-19) enrolled in the study. The majority of respondents felt popular (91%), happy (75.2%) and perceived themselves to have a good quality of life (86.8%). Despite this, 32% of females dieted, 29.4% were dissatisfied with their bodies, and 10.8% scored above 20 on the EAT-26. Adolescents always on a diet reported a lower quality of life (QoL) X2(16, N=2,961) =144.43, p <.000, perceived themselves to be less popular X2(15, N=2,963) =53.26, p <.000 and less academically able X2(16, N=2,297) =43.96, p<.000, than those who never dieted. Comparing EPICA values to published norms, Irish males had significantly lower EAT scores, females had comparable total EAT-26 scores but significantly lower levels of dieting and higher levels of bulimic features and oral control. Girls in mixed schools had higher rates of body dissatisfaction F (1,2855) = 16.61, p <.001 and drive for thinness F (1,2860) = 11.78, p <.005 than girls attending same sex schools. CONCLUSIONS: Weight and body image concerns were high among Irish adolescents, especially females, with higher than expected levels of bulimia and oral control scores on the EAT but lower scores on the dieting subscale. Females attending mixed sex schools appear most at risk of eating pathology.

Eating concerns and media influences in an Irish adolescent context.

OBJECTIVE: EPICA is the first large-scale Irish study of a school-going population examining the impact of media influences on eating attitudes. METHOD: Students were screened using the EAT-26, EDI-III and a study-specific questionnaire. A sub-sample of parents' views was included. RESULTS: Three thousand and thirty-one students (mean age 14.74) and 56 parents enrolled. The majority (71.4%) of adolescents felt adversely affected by media portrayal of body weight and shape, with more than a quarter (25.6%) believing it to be 'far too thin'. A significant correlation between media impact and high EAT scores (chi2 = 450.78, df = 2, p < 0.05) and EDI-III scores (chi2 = 387.51, df = 4, p < 0.05) was demonstrated. Parents also view media portrayal as too thin (94.7%), less than half are adversely affected by it (49.2%) but the majority (71.9%) believe their children to be. CONCLUSION: Media portrayal of body weight and shape is correlated with eating psychopathology and may affect adolescents more than adults. School psycho-educational programmes and media policies are urgently needed to minimise any detrimental effect.

Anorexia nervosa or otherwise? The usefulness of adult diagnostic systems in child and adolescent eating disorders.

We report on the case of a 15-year-old boy referred to Warrenstown inpatient unit for management of what appeared to be a typical case of anorexia nervosa. Over the course of his admission however, this diagnosis was no longer considered appropriate and substituted for a food avoidance emotional disorder. This is one of a number of cases of young males who have recently been referred for inpatient management of anorexia nervosa but which emerged into something quite atypical. The limited usefulness of the ICD-10/DSM-IV criteria in the diagnosis of an eating disorder in childhood and adolescence in this case reflects a broader level of discontent with the application of such diagnostic classification systems in a paediatric population.