Tanorexia criteria for better understanding sun overexposure in one of the Italian leading towns for melanoma incidence.

Background: Some people may compulsively desire to suntan despite the negative consequences, exhibiting symptoms similar to addictive disorders. Tanning dependence (TD) should be considered a risk factor leading to excessive sunbathing and thus increasing the risk of skin cancers. The aim of the present study was to investigate the tanning habits of the inhabitants of Trieste, a Northeastern Italian town characterized by high melanoma incidence. Predictors of tanning addiction were searched. The area of Trieste ranks second in Italy (after Turin) for melanoma incidence with standardized incidence rates very high in both sexes.

Methods: This study was based on an anonymous online survey of 520 randomly recruited adults who reported living in Trieste. TD was assessed using the mCAGE (modified Cut down, Annoyed, Guilty, Eye-opener) and the mDSM-IV-TR (modified Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision) questionnaires. Participants were classified as TD if positive on both questionnaires.

Results: Seventy-eight (15%) individuals were classified as TDs. The analyses compared TDs (N.=78, 15%) with non-TDs (N.=285, 55%) on various characteristics and behaviors. Females were significantly more represented in the TD group than males (P=0.03). Contrarily, TD did not vary with respect to age and Fitzpatrick skin type. High-risk tanning behaviors, including sun exposure in the middle hours of the day, long tanning sessions (more than 3 hours), and the use of sunbeds, were significantly related to TD.

Conclusions: Our results show that TD can be predicted by tanning behaviors. Increased knowledge of TD will help design appropriate interventions for different risk subgroups.