In this nation-wide register linkage study of the mortality among psychiatric in-patients with anorexia nervosa who were admitted between 1970 and 1986 (n = 853), 50 deaths were recorded during a mean follow-up period of 7.8 years (6680 person-years of observation). Among male subjects, five of 63 probands died, and the mean age at death was 24.5 years (range 14.2-48.1 years). Among female subjects, 45 of 790 probands died, and the mean age at death was 36 years (range 18.1-64.7 years). The standardized mortality ratio (SMR) was 9.1 in both sexes. A significantly increased SMR was demonstrated in males up to 5 years after index admission, and for females up to 15 years. There was no mortality among childhood-onset female subjects, but among males one death was recorded in this age group. In male subjects the highest SMR was found among those with index admission in the second decade of life, and in females among those with index admission in the third decade of life. The SMR was maximal during the first year after index admission. Suicide was the dominant cause of death among subjects who died from unnatural causes (18 of 22 cases). Among those who died from natural causes (24 subjects), 13 individuals died from anorexia nervosa and 11 individuals died from other illnesses.
From 1970 to 1989, 915 people were admitted for the first time to psychiatric institutions in Denmark and had as their main diagnosis an eating disorder, ICD-8 306.50-59. The incidence of these admissions increased from 0.42/100,000 population in 1970 to a maximum of 1.36/100,000 in 1988. During the time of our investigation, the number of discharges of patients with an eating disorder as the main diagnosis was constant from somatic hospitals, whereas discharges from psychiatric institutions increased.
Forty-six patients with schizophrenia or schizophreniform disorder admitted to hospital for the first time were compared with 21 healthy volunteers on neuropsychological tests reflecting prefrontal and left respectively right hemisphere function. The patients with schizophrenia or schizophreniform disorder had a poorer performance on neuropsychological tests (such as Wisconsin Card Sorting) compared with healthy volunteers. Both left and right hemisphere seemed to be involved. Especially poor performance was found on somewhat complicated tests requiring ability of analysis, abstraction and memory, thus indicating dysfunction of prefrontal and temporohippocampal regions. Signs of sulcal enlargement and size of lateral ventricles on computed tomographic scan correlated with poor test performance on some tests both in patients and in healthy volunteers. No correlations were found between performance on neuropsychological test and negative symptoms.
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