The incidence of anorexia nervosa on Curacao

Objective: Although anorexia nervosa was once thought to occur only in affluent societies, cases have now been documented across the globe. To examine whether anorexia nervosa emerges in societies undergoing socioeconomic transition, the authors studied the incidence of anorexia nervosa on the Caribbean island of Curacao.

Method: The authors contacted the full range of community health and service providers on Curacao, including dietitians, school counselors, and all 82 general practitioners. They also studied inpatient records for 84,420 admissions to Curacao General Hospital and two private hospitals in 1995 - 1998. Probable-incident subjects were interviewed.

Results: The incidence rates in 1995 1998 per 100,000 person-years for anorexia nervosa on Curacao were 1.82 (95% confidence interval [CI] = 0.74 - 2.89) for the total population and 17.48 (95% CI = 4.13 - 30.43) for the high-risk group of 15 - 24-year- old females. No cases were found among the majority black population. For the Curacao mixed and white population, the incidence rate per 100,000 person-years for anorexia nervosa was 9.08 ( 95% CI = 3.71 - 14.45).

Conclusions: The overall incidence of anorexia nervosa on Curacao is much lower than in the affluent societies of the United States and Western Europe. Within Curacao, sociocultural factors appear to be associated with differential incidence rates of anorexia nervosa. The incidence of anorexia nervosa among the majority black population is nil, while the incidence among the minority mixed and white population on Curacao is similar to that of the United States and the Netherlands.