Background. Empirical data regarding prevalence of sexual and physical abuse histories in Japanese
patients with eating disorders is lacking, in contrast to Western countries. This study investigated
the prevalence of traumatic events in Japanese patients with eating disorders, and examined the
relationship between such traumatic events and clinical features.
Methods. Subjects consisted of 33 patients with anorexia nervosa restricting type (RAN), 40
patients with anorexia nervosa binge eating/purging type (AN–BP), 63 patients with bulimia
nervosa purging type (BN) and 99 healthy controls. All were female and diagnoses were based on
DSM-IV. The Physical and Sexual Abuse Questionnaire (PSA), Eating Disorder Inventory (EDI)
and Dissociation Experience Scale (DES) were administered to all of the subjects.
Results. Paradoxically, victims of minor sexual abuse committed by Chikan (a Japanese word
indicating a person who commits minor sexual crimes) were more prevalent among controls than
among patients with RAN, AN–BP or BN. However, physical punishment histories tended to be
more prevalent among patients with AN–BP or BN than among RAN or controls. Only AN–BP
and BN patients with physical punishment histories had twofold higher scores for DES and
significantly more frequent histories of self-mutilation (67% v. 33%) compared with patients
without such histories.
Conclusion. An abuse history is not essential or a prerequisite to developing an eating disorder in
Japan.