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            <title xml:lang="en">Epidemiology of anorexia nervosa: A review</title>
            <title xml:lang="fr">Épidémiologie de l’anorexie mentale : revue de la littérature</title>
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                <forename>Nathalie</forename>
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            <idno type="halRefHtml">&lt;i&gt;L'Encéphale&lt;/i&gt;, 2013, 39 (2), pp.85-93. &lt;a target="_blank" href="https://dx.doi.org/10.1016/j.encep.2012.06.001"&gt;&amp;#x27E8;10.1016/j.encep.2012.06.001&amp;#x27E9;&lt;/a&gt;</idno>
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            <idno type="stamp" n="CHU-UNIV-PARIS5">Les centres hospitaliers de Paris Descartes</idno>
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                <title xml:lang="en">Epidemiology of anorexia nervosa: A review</title>
                <title xml:lang="fr">Épidémiologie de l’anorexie mentale : revue de la littérature</title>
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                    <surname>Chapelon</surname>
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                <title level="j">L'Encéphale</title>
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                  <biblScope unit="volume">39</biblScope>
                  <biblScope unit="issue">2</biblScope>
                  <biblScope unit="pp">85-93</biblScope>
                  <date type="datePub">2013-04</date>
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              <idno type="doi">10.1016/j.encep.2012.06.001</idno>
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                <term xml:lang="en">Anorexia nervosa</term>
                <term xml:lang="en">Prevalence</term>
                <term xml:lang="en">Incidence</term>
                <term xml:lang="en">Outcome</term>
                <term xml:lang="en">Mortality</term>
                <term xml:lang="fr">Mortalité</term>
                <term xml:lang="fr">Devenir</term>
                <term xml:lang="fr">Incidence</term>
                <term xml:lang="fr">Prévalence</term>
                <term xml:lang="fr">Anorexie mentale</term>
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              <p>A critical review of the literature was conducted to provide answers to three questions: firstly, are we facing a national and/or international epidemic of anorexia nervosa (AN)as claimed in the media by certain professionals? Secondly, is AN simply an ordinary crisis ofadolescence? Thirdly, is it a pathology that solely affects the higher socio-professional categories?Method. — A Medline search was conducted and backed up by a manual search to find all thestudies or literature reviews published on prevalence, incidence rates, outcomes, morbidityand mortality in AN and its links with social class, covering the period 2000—2011.Results. — The differing methodologies of the studies on these themes have a considerableimpact on the interpretation of results. For each indicator retained, the results observed in thedifferent studies are detailed and commented in the light of these differences. The prevalenceof AN in women aged 11 to 65 in non-clinical population ranges from 0 to 2.2 %. It varies in particular with the age of the studied subjects, the measurements used, and the definition criteriafor AN. Among men, the lifetime prevalence is around 0.3%. The marked disparities in incidence rates observed are related to the nature of the samples considered: subjects consultingin hospital, whether in a specialised department or in any department, those consulting generalpractitioners (GPs), or subjects from general population samples recruited in different surveys(girls in schools for example). The incidence of female cases is low in general medicine or specialised consultation in town (whatever the speciality): from 4.2 and 8.3/100,000 individuals peryear. It is much higher in the general population, ranging from 109 to 270/100,000 individualsper year. In fact, the studies reporting variations in the incidence of AN were conducted onsamples from clinical populations in certain countries (United States and United Kingdom).They are probably more a reflection of variations in detection rates and use of healthcare, thanof variations in the incidence in the general population. The mean duration of AN appears shorter in the general population than in clinical populations. On average, 47% of the individualstreated for AN recovered, 34% improved, 21% had a chronic eating disorder, and 5% died. Theoutcome is better for subjects treated during adolescence. Mortality is frequently expressedin crude mortality rate (CMR), which is not very informative on account of the heterogeneousnatures of the cohorts followed; only the studies reporting standardised mortality rate (SMR)are informative. AN appears as having one of the highest mortality rates among psychiatricpathologies. Mortality varies according to the population considered. Rates observed are 6.2to 10.6 times greater than that observed in the general population for a follow-up durationranging respectively from 13 to 10 years. It is lower for longer follow-up periods, only 3.7 timesmore frequent than in the general population for follow-up periods of 20 to 40 years. It appearslower for subjects treated before the age of 20. The main causes of death are eating disordercomplications, suicide and cancer. One review of the literature concluded in the absence ofany significant link between this pathology and social class.Discussion. — There is nothing in the incidence and prevalence data to back up the notion of arecent ‘‘epidemic’’ of AN. AN is not simply a crisis of adolescence: morbidity and mortality areconsiderable in this pathology. The relationship between AN and social class is not established.</p>
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              <p>Objectifs. — Nous avons réalisé une revue critique de la littérature afin de répondre à troisquestions : (1) Faisons-nous face à une « épidémie » nationale et/ou internationale d’anorexiementale (AM) comme le clament certains professionnels via les médias ? (2) L’AM n’est-ellequ’une banale crise d’adolescence ? (3) Est-ce une pathologie affectant exclusivement lescatégories socioprofessionnelles élevées ?Méthode. — Nous avons réalisé une recherche par Medline complétée par une recherchemanuelle pour retrouver toutes les études ou revues de la littérature publiées sur la prévalence, le taux d’incidence, le devenir, la morbidité et la mortalité de l’AM durant la période2000—2011.Résultats. — Les différences de méthodologie des études menées sur ces thèmes ont des conséquences importantes sur l’interprétation des résultats. Pour chaque indicateur retenu, nousdétaillons les résultats observés dans les différentes études et commentons à la lumière desdifférences méthodologiques.Discussion. — Rien n’appuie l’idée d’une épidémie récente d’AM. L’AM n’est pas une simplecrise d’adolescence compte tenu de la morbidité et de la mortalité qui sont considérables. Larelation entre l’AM et la classe socio-économique n’est pas prouvée</p>
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