Trends in hospital admissions for eating disorders in a country undergoing a socio-cultural transition, the Czech Republic 1981-2005

Objective: To test the hypothesis that the socio-cultural transition in the 1990s in Eastern Europe was associated with an increase in admissions for eating disorders (ED). Method: Cases of ICD-9 and ICD-10 ED in 1981, 1986 and 1992-2005 and first admissions for ICD-10 anorexia nervosa (AN) in 1994-2005 were retrieved from the Czech national register of hospital admissions. Age-and sexadjusted admission rates (per 100,000) were calculated and time trends tested by Poisson regression. Results: The admission rate for ED in females aged 10-39 quadrupled from 2.6 (95% CI 2.1-3.0) in 1981 to 10.6 (95% CI 9.8-11.5) in 2001, and remained elevated till 2005. The rate of first-time admissions for AN in 10-to 39-old females increased from 4.5 (95% CI 3.6-5.4) in 1994 to 7.5 (95% CI 6.3-8.6) in 1999, followed by a non-significant decrease. Conclusion: Temporal association of an increase in admissions with socio-cultural transition suggests that risk of severe ED including AN is culture-dependent.