The February 1993 Archives article by Chen et al1 is an important step toward a methodologically sound approach to the epidemiological study of psychiatric disorders in the Chinese community of Hong Kong. Only one female with DSM-III diagnosis for anorexia nervosa among 7229 subjects (3786 females and 3443 males; age range, 18 to 64 years) was identified, giving a low lifetime prevalence of 0.03% in females. It confirms the customary belief that anorexia nervosa is a condition "bound" to western cultures and is extremely rare in Chinese people.
However, such a presumptive belief should be tempered until factors relating to patients' presenting mode of distress, help-seeking behavior, investigators' alertness to abnormal eating behavior as psychiatric morbidity, and the diagnostic criteria used are elucidated. Regarding the Chinese, besides recent reports from Taiwan and Hong Kong2 on anorexia nervosa and bulimia nervosa, Song and Fang3 described nine females with
Lee S. The Diagnostic Interview Schedule and Anorexia Nervosa in Hong Kong. Arch Gen Psychiatry. 1994;51(3):251-252. doi:10.1001/archpsyc.1994.03950030087010