Epidemiology and natural course of eating disorders in young women from adolescence to young adulthood.

OBJECTIVES To describe the epidemiology of eating disorders (ED) in a community sample of adolescent girls; to compare the clinical characteristics of full-syndrome (FS) and partial-syndrome (PS) ED cases; and to provide information about the continuity between adolescent ED and young adult psychopathology. METHOD A randomly selected sample of high school girls were assessed during adolescence (n = 891) and a year later (n = 810), and a stratified subset (n = 538) was assessed during their 24th year. The assessments included the Schedule for Affective Disorders and Schizophrenia for School-Age Children, the Longitudinal Interval Follow-up Evaluation, level of functioning, mental health treatment utilization, history of suicide attempt, and physical symptoms. RESULTS The incidence of ED was less than 2.8% by age 18, and 1.3% for ages 19 through 23. Comorbidity with other psychopathology (89.5%), but especially depression, was very high. FS- and PS-ED groups differed significantly from a no-disorder comparison group on most outcome measures, and more than 70% of the adolescent FS- and PS-ED cases met criteria for an Axis I disorder in young adulthood. CONCLUSIONS FS- and PS-ED are associated with substantial comorbidity, treatment seeking, impaired functioning, and risk for psychopathology in young adulthood.