Does bulimia nervosa exist in children?

Although prepubertal anorexia nervosa has been well described, prepubertal bulimia nervosa seems uncommon. In a retrospective study of the 262 inpatie nts with eating disorders in our department of child and adolescent psychia try from 1988 through 1994, only one patient under 13 fulfilled bulimia ner vosa DSM-III-R criteria, and she was a premenarchal patient and not a prepu bertal patient. Concerning the large group of eating disorders not otherwise specified, und er thirteen and Tanner stage 1 or 2, we could find different cases of patie nts with some but not all of the criteria of bulimia nervosa. So, we think that "atypical" bulimia nervosa exists in prepubertal patients, but more pr actical diagnosis criteria are necessary for children.