Mortality in anorexia nervosa in Denmark during the period 1970‐1987

Abstract

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.

Ten‐year follow‐up of adolescent‐onset anorexia nervosa: physical health and neurodevelopment

“…However, in AN with teenage onset a low mortality rate may be expected (Møller-Madsen et al 1996). Further, the size of this sample may be too small to detect mortality differences.…”

“…Mortality rates in follow-up studies vary from 0% (IC Gillberg et al 1994, Strober et al 1997) to 23.8% (Hentze and Engel 1991), with somatic sequelae explaining 52% (Møller-Madsen et al 1996) to 76% (Hentze and Engel 1991) of the mortality.…”

Anorexia Nervosa

“…AN has the highest mortality rate of any psychiatric illness (Sullivan, 1995). The standardized mortality ratio ranges from 1.36 (among females 20 years following treatment) to 30.5 (among females less than 1 year following treatment) (Birmingham, Su, Hlynsky, Goldner, & Gao, 2005;Eckert, Halmi, Marchi, Grove, & Crosby, 1995;Herzog et al, 2000;Keel et al, 2003;Lee, Chan, & Hsu, 2003;Møller-Madsen, Nystrup, & Nielsen, 1996). Based on an analysis of studies published between 1966 and 1995, premature all-cause death risk in individuals with AN was 5 times higher than expected, due to increased rates of premature death from both natural (4 times higher than expected) and unnatural (11 times higher than expected) causes (Harris & Barraclough, 1998).…”

Algumas questões éticas no tratamento da anorexia nervosa

“…Entre os transtornos alimentares (TA), representa o menos comum, porém o mais grave 2 . Nos pacientes com a doença, as principais causas de morte são o suicídio e os efeitos diretos do jejum 3,4 .É uma patologia com relativa baixa prevalência (0,5% a 1% em alguns estudos nos Estados Unidos), incidindo, mais comumente, em mulheres com idades entre 15 a 29 anos 5 ; no entanto, sua mortalidade é alta. Sullivan 6 , em uma metanálise englobando 42 estudos sobre mortalidade na AN estimou que a mortalidade fosse de 5,6% por década desde o início da doença.…”

“…Entre os transtornos alimentares (TA), representa o menos comum, porém o mais grave 2 . Nos pacientes com a doença, as principais causas de morte são o suicídio e os efeitos diretos do jejum 3,4 .…”