Anorexia nervosa in Greek and Turkish adolescents

Five samples of adolescents were assessed in three countries: (1) 867 Greek pupils in Munich (Germany), (2) 2,700 Greek pupils in Veria (Greece), (3) 567 girls in Ioannina (Greece), (4) 2,783 adolescents in Istanbul (Turkey), and (5) 157 adolescents in Upper Bavaria (Germany). A two-stage procedure was used for samples one, two and four using the Anorexia Nervosa Inventory for Self-rating (ANIS) for screening and a standardized interview (Structured Interview for Anorexia Nervosa and Bulimia) for personal exploration of possible cases and final case identification. Results of all samples were compared. Greek girls in Germany scored higher than Greek boys in Germany and Greek boys and girls in Germany scored lower than Greek girls in Veria in the ANIS factors figure consciousness, insufficiency, anancasm, negative effect of meals and bulimia in practically all age groups. The frequency distribution of the ANIS main factor figure consciousness was the same for both Greek samples in Greece, while the Turkish sample and the Greek sample in Munich had significantly lower scores. In the second stage the prevalence rates for anorexia nervosa according to Feighner criteria (modified for the purpose of a field study) were: 1.10% for Greek girls in Munich, 0.41% for Greek girls in Veria and 0.35% for Greeks in Ioannina. Thus, while Greek girls in Germany had lower scores in ANIS factors and other self-ratings (General Health Questionnaire) the actual rate of anorexic syndromes was highest among Greek girls in Munich. Socio-cultural influences and selection factors are discussed.