Cross-Cultural Adaptation and Psychometric Validation of the Turkish Düsseldorf Orthorexia Scale in Adolescents

Purpose Orthorexia nervosa (ON) is an excessive preoccupation with healthy eating that can lead to rigidity, impairment, and distress. Validated tools to assess ON in adolescent psychiatry settings are scarce. This study evaluated the validity and reliability of the Turkish version of the Düsseldorf Orthorexia Scale (TR-DOS) in an adolescent clinical sample. Methods Adolescents aged 12–18 presenting to a child and adolescent psychiatry outpatient clinic completed the TR-DOS, Orthorexia Nervosa Inventory, Eating Attitudes Test-26, and Revised Child Anxiety and Depression Scale – Child Version. Psychiatric diagnoses were established through clinician-administered DSM-5 interviews. Construct validity was examined with confirmatory factor analysis. Internal consistency was assessed using Cronbach’s α and McDonald’s ω. Convergent validity was evaluated via correlations with related measures. Receiver operating characteristic analysis was used to determine an optimal cut-off. Results The sample comprised 209 adolescents (61.2% female; mean age = 15.7 years). Model fit indices supported a one-factor solution (χ²/df = 2.00; CFI = 0.961; TLI = 0.944; RMSEA = 0.0688; SRMR = 0.0443). Internal consistency was high (α = 0.868; ω = 0.871). TR-DOS scores correlated positively with orthorexic symptomatology and disordered eating (r = 0.595 and r = 0.374, both p < .001). A cut-off score of 26 yielded an AUC of 0.968, with 91.2% sensitivity and 100% specificity. Only obsessive–compulsive disorder was significantly associated with higher TR-DOS scores. Conclusion The TR-DOS is a valid, reliable, and practical tool for assessing orthorexic tendencies in Turkish adolescents and may facilitate early identification and clinical decision-making. Level of evidence Level V, descriptive study