Document Detail

A longitudinal investigation of mortality in anorexia nervosa and bulimia nervosa.
MedLine Citation:
PMID:  23771148     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE Although anorexia nervosa has a high mortality rate, our understanding of the timing and predictors of mortality in eating disorders is limited. The authors investigated mortality in a long-term study of patients with eating disorders. METHOD Beginning in 1987, 246 treatment-seeking female patients with anorexia nervosa or bulimia nervosa were interviewed every 6 months for a median of 9.5 years to obtain weekly ratings of eating disorder symptoms, comorbidity, treatment participation, and psychosocial functioning. From January 2007 to December 2010 (median follow-up of 20 years), vital status was ascertained with a National Death Index search. RESULTS Sixteen deaths (6.5%) were recorded (lifetime anorexia nervosa, N=14; bulimia nervosa with no history of anorexia nervosa, N=2). The standardized mortality ratio was 4.37 (95% CI=2.4-7.3) for lifetime anorexia nervosa and 2.33 (95% CI=0.3-8.4) for bulimia nervosa with no history of anorexia nervosa. Risk of premature death among patients with lifetime anorexia nervosa peaked within the first 10 years of follow-up, resulting in a standardized mortality ratio of 7.7 (95% CI=3.7-14.2). The standardized mortality ratio varied by duration of illness and was 3.2 (95% CI=0.9-8.3) for patients with lifetime anorexia nervosa for 0 to 15 years (4/119 died), and 6.6 (95% CI=3.2-12.1) for those with lifetime anorexia nervosa for >15 to 30 years (10/67 died). Multivariate predictors of mortality included alcohol abuse, low body mass index, and poor social adjustment. CONCLUSIONS These findings highlight the need for early identification and intervention and suggest that a long duration of illness, substance abuse, low weight, and poor psychosocial functioning raise the risk for mortality in anorexia nervosa.
Debra L Franko; Aparna Keshaviah; Kamryn T Eddy; Meera Krishna; Martha C Davis; Pamela K Keel; David B Herzog
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  The American journal of psychiatry     Volume:  170     ISSN:  1535-7228     ISO Abbreviation:  Am J Psychiatry     Publication Date:  2013 Aug 
Date Detail:
Created Date:  2013-08-01     Completed Date:  2013-09-30     Revised Date:  2014-11-14    
Medline Journal Info:
Nlm Unique ID:  0370512     Medline TA:  Am J Psychiatry     Country:  United States    
Other Details:
Languages:  eng     Pagination:  917-25     Citation Subset:  AIM; IM    
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MeSH Terms
Age Factors
Age of Onset
Alcoholism / diagnosis,  mortality,  psychology
Anorexia Nervosa / diagnosis,  mortality*,  psychology
Body Mass Index
Bulimia Nervosa / mortality*
Longitudinal Studies
Multivariate Analysis
Social Adjustment
Survival Analysis
Young Adult
Grant Support
Comment In:
Am J Psychiatry. 2013 Aug;170(8):824-5   [PMID:  23903330 ]
Am J Psychiatry. 2014 Feb;171(2):229   [PMID:  24500464 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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