We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
Online ordering will be unavailable from 17:00 GMT on Friday, April 25 until 17:00 GMT on Sunday, April 27 due to maintenance. We apologise for the inconvenience.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure [email protected]
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Personality disorders, characterised by pervasive emotional and interpersonal dysfunction, are integral to psychiatric practice. This service review estimated the prevalence of personality disorders in a psychiatric inpatient setting and looked at various clinical and demographic factors of interest.
Methods:
Data were retrospectively collected from 526 patients discharged from St Patrick’s University Hospital in 2019–2020 under the care of two consultant-led teams. Demographic and clinical data such as age of first mental health contact, number of previous admissions, and risk history were recorded as well as the use of the Structured Clinical Interview for DSM-5 Personality Disorders (SCID-5-PD).
Results:
37% of the sample had at least one personality disorder, with borderline (24.9%), avoidant (13.3%) and obsessive-compulsive (7.6%) being the most common subtypes. Notably, in 72.1% of cases the diagnosis was new. High comorbidity was observed, particularly with affective (47.7%) and anxiety disorders (28.4%). Patients with personality disorders exhibited high rates of self-harm (45%) and suicide attempts (40%).
Discussion:
The review highlighted potential delays in diagnosis, with an average of 15 years of mental health service contact prior to diagnosis. The findings underscore the need for specialised services and further research to better understand and manage personality disorders in the Irish psychiatric setting. Limitations include the specific sample from a private mental health facility and the high use of structured interviews, which may affect the generalisability of the results to other settings. This review contributes valuable data to the limited research on personality disorder prevalence in Irish psychiatric services.
Adverse childhood experiences (ACEs) are prevalent in people with substance use disorder (SUD). The aims of this study were to determine the prevalence of ACEs in a specific sample of people with SUD and to analyze the specific characteristics of these patients according to gender. The studied sample consisted of 215 people seeking treatment for SUD in two clinical centers in Spain. Descriptive and comparison analyses were carried out, and a logistic regression analysis was conducted to identify the main variables related to ACEs. The prevalence of at least one ACE was 82.3%. Women reported a higher prevalence of family mental health problems (p = .045; d = 0.14) and sexual abuse (p < .001; d = 0.43) than men. The group with ≥3 ACEs showed a higher severity profile for the addiction severity and psychopathological variables than the groups with 0 ACEs and 1–2 ACEs. Logistic regression showed that problems related to the group with ≥3 ACEs in the total sample were psychiatric and legal problems and lifetime suicidal ideation (in men, family/social problems and lifetime suicidal ideation; in women, employment/support problems). This study supports the high prevalence of ACEs in people with SUD and the cumulative effect of ACEs. In addition, gender is a relevant factor. The implementation of assessments and treatment for ACEs is necessary in SUD treatment programs.
The impact of macroparasites on their hosts is proportional to the number of parasites per host, or parasite abundance. Abundance values are count data, i.e. integers ranging from 0 to some maximum number, depending on the host–parasite system. When using parasite abundance as a predictor in statistical analysis, a common approach is to bin values, i.e. group hosts into infection categories based on abundance, and test for differences in some response variable (e.g. a host trait) among these categories. There are well-documented pitfalls associated with this approach. Here, I use a literature review to show that binning abundance values for analysis has been used in one-third of studies published in parasitological journals over the past 15 years, and half of the studies in ecological and behavioural journals, often without any justification. Binning abundance data into arbitrary categories has been much more common among studies using experimental infections than among those using naturally infected hosts. I then use simulated data to demonstrate that true and significant relationships between parasite abundance and host traits can be missed when abundance values are binned for analysis, and vice versa that when there is no underlying relationship between abundance and host traits, analysis of binned data can create a spurious one. This holds regardless of the prevalence of infection or the level of parasite aggregation in a host sample. These findings argue strongly for the practice of binning abundance data as a predictor variable to be abandoned in favour of more appropriate analytical approaches.
Ito et al present an illness–death model projecting 82 scenarios for the prevalence of anxiety disorders in Germany from 2019 to 2030 following the COVID-19 pandemic. We suggest the modelling framework used by Ito et al has promising applications for mental health epidemiology.
The prevalence of co-morbid anxiety and depression varies greatly between research studies, making it difficult to understand and estimate the magnitude of this problem. This systematic review and meta-analysis aim to provide up-to-date information on the global prevalence of co-morbid anxiety and depression in pregnant and postpartum women and to further investigate the sources of heterogeneity. Systematic searches of eight electronic databases were conducted for original studies published from inception to December 10, 2024. We selected studies that directly reported prevalence data on co-morbid anxiety and depression during the perinatal periods. We extracted data from published study reports and calculated the pooled prevalence of symptoms of co-morbid anxiety and depression. There are 122 articles involving 560,736 women from 43 different countries included in this review. The global prevalence of co-morbid anxiety and depression during the perinatal period was about 9% (95%CI 8%–10%), with approximately 9% (95%CI 8%–11%) in pregnant women and 8% (95%CI 7%–10%) in postpartum women. Prevalence varied significantly by the assessment time points, study country, study design, and the assessment tool used for anxiety and depression, while prevalence was not dependent on publication year, country income level, and COVID-19 context. No publication bias was observed for this prevalence rate. These findings suggest that approximately 1 in 10 women experience co-morbid anxiety and depression during pregnancy and postpartum. Targeted action is needed to reduce this burden.
Depression and anxiety are common mental health issues globally, yet limited research has focused on job seekers in Bangladesh. This study examines the prevalence and associated factors of depression and anxiety symptoms among Bangladeshi graduates seeking employment. A cross-sectional study was conducted among graduates from two public universities in Bangladesh, using face-to-face interviews and a semi-structured questionnaire. Data were collected between March and April 2024 through convenience sampling. Chi-square tests and logistic regression were used for analysis with SPSS software. Among the participants, 46.8% experienced depressive symptoms and 67.8% had anxiety symptoms, with 42.3% experiencing both. Factors associated with a reduced risk of depressive symptoms included being a first child (OR = 0.48, 95% CI: 0.25–0.93, p = 0.031) and exam satisfaction (OR = 0.22, 95% CI: 0.12–0.39, p < 0.001). Lower symptoms of anxiety were associated with being male (OR = 0.45, 95% CI: 0.25–0.80, p = 0.007), first-born status (OR = 0.45, 95% CI: 0.22–0.92, p = 0.030), financial contribution to family (OR = 0.40, 95% CI: 0.19–0.81, p = 0.011), over 12 months of preparation (OR = 0.37, 95% CI: 0.15–0.92, p = 0.034) and exam satisfaction (OR = 0.40, 95% CI: 0.22–0.71, p = 0.002). Intentionally unemployed participants had a higher risk of anxiety symptoms (OR = 1.70, 95% CI: 1.00–2.89, p = 0.046). This study reveals high rates of depressive and anxiety symptoms among job-seeking graduates in Bangladesh. Socio-demographic and job-related factors appear to significantly impact mental health, underscoring the need for a holistic approach to address these challenges. Targeted mental health interventions and increased public awareness are essential to support vulnerable groups in navigating the highly competitive job market.
Clostridiodes difficile’s epidemiology has evolved over the past decades, being recognized as an important cause of disease in the community setting. Even so, there has been heterogeneity in the reports of CA-CDI. Therefore, the aim of this study was to assess the epidemiologic profile of CA-CDI.
This systematic review and meta-analysis were conducted according to PRISMA checklist and Cochrane guidelines (CRD42023451134). Literature search was performed by an experienced librarian from inception to April 2023, searching in databases like MEDLINE, Scopus, Web of Science, EMBASE, CCRCC, CDSR, and ClinicalTrials. Observational studies that reported prevalence, incidence of CA-CDI, or indicators to calculate them were included. Pool analysis was performed using a binomial-normal model via the generalized linear mixed model. Subgroup analysis and publication bias were also explored. A total of 49 articles were included, obtaining a prevalence of 5% (95% CI 3–8) and an incidence of 7.53 patients (95% CI 4.45–12.74) per 100,000 person-years.
In conclusion, this meta-analysis underscores that among the included studies, the prevalence of CA-CDI stands at 5%, with an incidence rate of 7.3 cases per 100,000 person-years. Noteworthy risk factors identified include prior antibiotic exposure and age.
This systematic review and meta-analysis examined 27 studies published between 2003 and 2024 to assess the prevalence of Fasciola hepatica infestation in various animal species in Algeria. Diagnostic methods included liver inspection (16 studies), ELISA (7 studies), coproscopy (4 studies), bile microscopy (1 study), and abattoir data analysis (1 study). For humans, coproscopy and immunoelectrophoresis (IEP) were used in one study in Algiers. Among the 1,006,751 animals examined, 15,868 tested positive, resulting in an overall prevalence of 1.57% (CI 1.55–1.59). Prevalence was higher in the northeastern regions of Algeria (El Tarf, Annaba, and Jijel) at 15.95%, compared to other regions (0.9%–2.95%) (p<0.0001). Cattle showed the highest prevalence (3.91%; CI 3.84–3.98) (p<0.001), followed by sheep (0.42%; CI 0.40–0.44) and goats (0.12%; CI 0.10–0.14). Camels had a prevalence rate of 4%. Trend analysis over 20 years indicated a progressive decrease in prevalence, from 13.29% (2004–2009) to 1.79% (2010–2019) and 1.12% (2020–2024) (p<0.0001). The ELISA method was found to be the most sensitive, revealing a prevalence of 16.40% (CI 15.23–17.57) (true adjusted prevalence is 12.38%) (p<0.0001), significantly higher than liver inspection (1.83%), coproscopy (1.04%), and abattoir data analysis (1.10%). Prevalence increased with animal age across all species. This study clearly shows that fasciolosis in Algeria is most prevalent in the northeast region and that cattle are the high-risk group of animals. As a result, control strategies are urgently needed, targeting cattle in particular in northeast Algeria, to prevent and control this disease and thus reduce Fasciola infection.
Living with major depressive disorder (MDD) reduces life expectancy, with respiratory disease being a significant threat. However, evidence on respiratory disease in this population has not yet been meta-analyzed.
Methods
This meta-analysis examines respiratory disease prevalence and odds ratio (OR) in patients with MDD and treatment resistant depression (TRD). A systematic literature search was conducted, with a snowball search of reference and citation lists. Inclusion criteria covered studies in MDD and TRD patients with confirmed diagnoses of respiratory diseases (asthma, chronic obstructive pulmonary disease [COPD], pneumonia, lung cancer, and tuberculosis), comparing with a control group when possible.
Results
From 4,138 retrieved articles, 15 (including 476,927 individuals with MDD, 50,680 with TRD, and 1,108,979 control group) met the inclusion criteria. In MDD patients, COPD prevalence was 9.0% (95% CI: 3.8–19.6%), asthma 8.6% (95% CI: 5.7–12.8%), and pneumonia 2.5% (95% CI: 2.2–2.9%). In TRD patients, COPD prevalence was 9.9% (95% CI: 4.2–21.9%) and asthma 10.9% (95% CI: 10.7–11.2%), but meta-analysis limited to those diseases showed no significant relative risk differences. Compared to the general population, individuals with MDD had significantly higher rates of COPD (OR 1.79, 95% CI: 1.49–2.16), even higher in younger populations (1.85 [95% CI: 1.74–1.97]) and more prevalent in women.
Conclusions
This first meta-analysis on this topic shows that MDD is associated with an increased risk of respiratory illness compared to the general population. The prevalence of asthma doubles the mean described in the general population worldwide, and in COPD, women and younger people are at particular risk. Prevention policies are urgently needed.
Depressive and anxiety disorders constitute a major component of the disease burden of mental disorders in China.
Aims
To comprehensively evaluate the disease burden of depressive and anxiety disorders in China.
Method
The raw data is sourced from the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2021. This study presented the disease burden by prevalence and disability-adjusted life years (DALYs) of depressive and anxiety disorders at both the national and provincial levels in China from 1990 to 2021, and by gender (referred to as 'sex' in the GBD 2021) and age.
Results
From 1990 to 2021, the number of depressive disorder cases (from 34.4 to 53.1 million) and anxiety disorders (from 40.5 to 53.1 million) increased by 54% (95% uncertainty intervals: 43.9, 65.3) and 31.2% (19.9, 43.8), respectively. The age-standardised prevalence rate of depressive disorders decreased by 6.4% (2.9, 10.4), from 3071.8 to 2875.7 per 100 000 persons, while the prevalence of anxiety disorders remained stable. COVID-19 had a significant adverse impact on both conditions. There was considerable variability in the disease burden across genders, age groups, provinces and temporal trends. DALYs showed similar patterns.
Conclusion
The burden of depressive and anxiety disorders in China has been rising over the past three decades, with a larger increase during COVID-19. There is notable variability in disease burden across genders, age groups and provinces, which are important factors for the government and policymakers when developing intervention strategies. Additionally, the government and health authorities should consider the potential impact of public health emergencies on the burden of depressive and anxiety disorders in future efforts.
Insomnia is common, affecting approximately 10% of the population. In addition to night-time sleep difficulties, insomnia disorder requires the presence of concomitant daytime impacts, making it a 24-hour problem. It is not surprising, therefore, that insomnia disorder is associated with significant impacts to quality of life and economic costs. Many patients with insomnia also have comorbid physical and/or mental health disorders, and sometimes also other sleep disorders. This chapter reviews the key features, prevalence, and consequences of insomnia disorder, and provides background information to aid clinicians as they begin to think about formulating treatment approaches.
Systematic review and meta-analysis were conducted to provide comprehensive information on the prevalence of amphistome infections in domestic ruminants in sub-Saharan Africa. A systematic search of peer-reviewed articles published between 2002 and 2023 was conducted. Prevalence estimates and meta-analysis were based on 76 peer-reviewed articles which met the inclusion criteria. Of the 55,122 domestic ruminants screened, 12,858 were infected, and the overall pooled prevalence was 22% (95% confidence interval [CI], 10-37). The highest prevalence was recorded in southern Africa 25% (95% CI, 0-62), and central Africa 16% (95% CI, 0-61) the lowest. Cattle were the most frequently sampled hosts (76.56%, n = 42,202) and sheep (8.78%, n = 4838) the lowest, and cattle recorded the highest pooled prevalence of 28% (95% CI, 12-47), and goats the lowest at 5% (95% CI, 0-14). Prevalence rate was the high in males 32% (95% CI, 21-44), adult ruminants 37% (95% CI, 15-62) and animals with poor body condition 47% (95% CI, 34-60), and during the wet season 36% (95% CI, 0-94). The highest pooled prevalence was recorded at postmortem 23% (95% CI, 8-43) compared to coprology 20% (95% CI, 6-39) studies. The meta-regression model demonstrated that the body condition score, host, and period, and the interactions of different factors significantly influenced the prevalence. The lowest prevalence rate was noted for the period between 2013 and 2023. This is the first systematic review and meta-analysis in sub-Saharan Africa that provides a comprehensive review of the prevalence of amphistome infections in domestic ruminants in the past 20 years.
The prevalence of mental health disorders has significantly increased in recent years, posing substantial challenges to healthcare systems worldwide, particularly primary care (PC) settings. This study examines trends in mental health diagnoses in PC settings in Catalonia from 2010 to 2019 and identifies associated sociodemographic, clinical characteristics, psychopharmacological treatments, and resource utilization patterns.
Methods
Data from 947,698 individuals without prior severe mental illness, derived from the Data Analytics Program for Health Research and Innovation (PADRIS), were analyzed for this study. Sociodemographic data, diagnoses, and resource utilization were extracted from electronic health records. Descriptive statistics, chi-square tests, Mann–Whitney tests, and a multivariate binary logistic regression were employed to analyze the data.
Results
Over the study period, 172,112 individuals (18.2%) received at least one mental health diagnosis in PC, with unspecified anxiety disorder (40.5%), insomnia (15.7%) and unspecified depressive disorder (10.2%) being the most prevalent. The prevalence of these diagnoses increased steadily until 2015 and stabilized thereafter. Significant associations were found between mental health diagnoses, female sex, lower socioeconomic status, higher BMI, and smoking status in a multivariate binary logistic regression.
Conclusions
This study highlights a growing burden of stress-related mental health diagnoses in PC in Catalonia, driven by demographic and socioeconomic factors. These findings may be indicative of broader trends across Europe and globally. Addressing this rising prevalence requires innovative approaches and collaborative strategies that extend beyond traditional healthcare resources. Engaging stakeholders is essential for implementing effective, sustainable solutions that promote mental health in Catalonia and potentially inform similar initiatives worldwide.
The WHO describes micronutrient deficiencies, or hidden hunger, as a form of malnutrition that occurs due to low intake and/or absorption of minerals and vitamins, putting human development and health at risk. In many cases, emphasis, effort and even policy revolve around the prevention of deficiency of one particular micronutrient in isolation. This is understandable as that micronutrient may be among a group of nutrients of public health concern. Vitamin D is a good exemplar. This review will highlight how the actions taken to tackle low vitamin D status have been highly dependent on the generation of new data and/or new approaches to analysis of existing data, to help develop the evidence-base, inform advice/guidelines, and in some cases, translate into policy. Beyond focus on individual micronutrients, there has also been increasing international attention around hidden hunger, or deficiencies of a range of micronutrients, which can exist unaccompanied by obvious clinical signs but can adversely affect human development and health. A widely quoted estimate of the global prevalence of hidden hunger is a staggering two billion people, but this is now over 30 years old. This review will outline how strategic data sharing and generation is seeking to address this key knowledge gap in relation to the true prevalence of hidden hunger in Europe, a key starting point towards defining sustainable and cost-effective, food-based strategies for its prevention. The availability of data on prevalence and food-based strategies can help inform public policy to eradicate micronutrient deficiency in Europe.
Echinococcosis is a parasitic invasion caused by a cestode of the genus Echinococcus. Kyrgyzstan is a country in Central Asia known for an extremely high incidence of echinococcosis. A total of 10 093 subjects were screened in the Osh, Naryn and Batken regions of Kyrgyzstan in 2015–2017 by ultrasound and questioned for potential risk factors. Cystic echinococcosis (CE) prevalence (combined newly diagnosed and post-surgery cases) ranged between 0.2 and 25.2% across the study regions. Typical factors, such as dog or livestock ownership, weakly affected CE risk (odds ratio [OR] = 1.18–1.83). Use of water from a well and owning a cat had a greater effect on CE risk (OR = 2.02–2.28). The risk factors of CE were highly dissimilar among the study regions, with patterns not always compatible with classical biohelminthosis transmission routes (no risk from livestock in certain areas, significant risk from using well water, owning cats). Therefore, the CE epidemic in Kyrgyzstan is not holistic in terms of potential mechanisms and risk factors, and certain areas can greatly benefit from preventive measures that will have limited efficiency elsewhere.
Youth in sub-Saharan Africa (SSA) face limited access to professional mental health resources. A comprehensive assessment of the prevalence of mental disorders would build an understanding of the scope of the need.
We conducted systematic searches in PsycInfo, Pubmed, AfriBib and Africa Journals Online to identify prevalence rates for five disorders (anxiety, depression, conduct disorder, attention problems and post-traumatic stress) among SSA youth with a mean age of less than 19 years. We calculated a random-effects pooled prevalence for each disorder and assessed possible moderators.
The meta-analysis included 63 studies with 55,071 participants. We found the following pooled prevalence rates: 12.53% post-traumatic stress disorder (PTSD), 15.27% depression, 6.55% attention-deficit hyperactivity disorder, 11.78% anxiety and 9.76% conduct disorder. We found high heterogeneity across the studies, which may have resulted from differences in samples or measurement tools. Reported prevalence rates were not explained by the sample (i.e., special or general population), but whether the psychometric tool was validated for SSA youth affected the reported prevalence of PTSD and anxiety. In a meta-regression, prevalence rates were associated with the disorder type, with a higher prevalence of depression and PTSD. We found the mean age significantly moderated the prevalence in univariate meta-regression, with increased age correlated with greater prevalence.
Our findings suggest there is a need to explore reasons for varying prevalence rates further and to develop interventions that support youth mental health in SSA, particularly interventions for depression and PTSD. Limitations included a lack of standardization in psychometric tools and limited reporting on research methods, which influenced quality rating. Importantly, the search only considered studies published in English and was conducted 2 years ago. Although recent estimates reported slightly higher than our prevalence estimates, these reviews together highlight the prevalence and importance of youth mental health difficulties in SSA.
The goal of public health is to improve the overall health of a population by reducing the burden of disease and premature death. In order to monitor our progress towards eliminating existing problems and to identify the emergence of new problems, we need to be able to quantify the levels of ill health or disease in a population. Researchers and policy makers use many different measures to describe the health of populations. In this chapter we introduce more of the most commonly used measures so that you can use and interpret them correctly. We first discuss the three fundamental measures that underlie both the attack rate and most of the other health statistics that you will come across in health-related reports, the incidence rate, incidence proportion (also called risk or cumulative incidence) and prevalence, and then look at how they are calculated and used in practice. We finish by considering other, more elaborate measures that attempt to get closer to describing the overall health of a population. As you will see, this is not always as straightforward as it might seem.
The aim of this study was to investigate factors associated with reported need of weight loss support among adults with overweight or obesity in the general population.
Design:
A cross-sectional population study based on a survey questionnaire sent to a random population sample. Multivariate odds ratios for reported need of weight loss support were calculated for socio-economic, lifestyle and health indicators, in total and by gender and age group.
Setting:
Five counties in Sweden in 2022.
Participants:
The study includes 10 069 persons with overweight or obesity (BMI ≥ 25 kg/m2) aged 30–69 years. BMI was based on self-reported weight and height.
Results:
In total, about 20 % reported needing weight loss support. The factors most strongly associated with reported need of weight loss support were obesity and female gender. Lack of social support, economic difficulties, physical inactivity, poor self-rated health, musculoskeletal pain and depression were also associated with reported need of weight loss support, whereas diabetes and hypertension were not. Some differences in these associations were observed between age groups.
Conclusion:
Reported need of weight loss support is more common among women than among men and associated with obesity, lack of social support, economic difficulties, physical inactivity, poor self-rated health, musculoskeletal pain and depression in both genders. These factors are important for planning preventive and weight-control measures among adults with overweight or obesity.
This study aimed to estimate the nationwide prevalence of cardiometabolic diseases (CMD) among adults with underweight in the US general population. Using data from the National Health and Nutrition Examination Survey (1999–2020), we estimated the age-standardised prevalence of dyslipidemia, hypertension, diabetes, chronic kidney disease, CVD and the presence of zero or at least two CMD. Multivariable Poisson regressions were used to compare CMD prevalence between subgroups, adjusting for age, sex and race/ethnicity. Among the 855 adults with underweight included, the weighted mean age was 40·8 years, with 68·1 % being women and 70·4 % non-Hispanic White. The estimated prevalence rates were 23·4 % for dyslipidemia (95 % CI 19·4 %, 27·5 %), 15·6 % for hypertension (95 % CI 13·3 %, 17·8 %), 2·5 % for diabetes (95 % CI 1·5 %, 3·5 %), 7·9 % for chronic kidney disease (95 % CI 6·9 %, 8·8 %) and 6·1 % for CVD (95 % CI 4·3 %, 7·9 %). The prevalence of having zero and at least two CMD was 50·6 % (95 % CI 44·1 %, 57·0 %) and 12·3 % (95 % CI 8·1 %, 16·4 %), respectively. Non-Hispanic Black adults had significantly higher prevalence of diabetes (adjusted prevalence ratio, 3·35; 95 % CI 1·35, 8·30) compared with non-Hispanic White adults. In conclusion, approximately half of the underweight adults had at least one CMD, and 12·3 % had at least two CMD. Prevention and management of CMD in underweight adults are critical yet neglected public health challenges.
Part III provides brief descriptions of the most frequently used self-reported questionnaires (ORTO-15, Eating Habits Questionnaire, Düsseldorf Orthorexia Scale, Teruel Orthorexia Scale, Barcelona Orthorexia Scale, Orthorexia Nervosa Inventory, ORTO-R, Orthorexia Self-Test), to outline those that seem to be suitable as self-assessment tools to measure orthorexia nervosa and those that are promising in research and clinical settings. It also proposes Orthorexia Nervosa Screening Questions to detect the risk of orthorexia nervosa. A summation of the highlights is included at the end of this chapter. The commentary of the invited international expert (Dr Adrian Meule, the University Hospital of the LMU Munich and the Schoen Clinic Roseneck, Germany ) provides valuable insights on orthorexia nervosa.