Mortality Rates in Patients With Anorexia Nervosa and Other Eating Disorders

Arcelus, Jon; Mitchell, Alex J.; Wales, Jackie; Nielsen, Søren R.K.

doi:10.1001/archgenpsychiatry.2011.74

Cited by 2,196 publications

(1,636 citation statements)

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“…It has been documented in many studies that chronically ill, low-weight AN patients such as the one in our study do have a much increased mortality risk. 72 The causes of death typically are related directly to consequences or complications of the illness (via malnutrition or abnormal weight control methods), and this is thought to be the case here. Previous trials of AN outpatient treatment in adults have reported deaths.…”

Section: Harmsmentioning

confidence: 99%

“…[72][73][74][75][76][77] Universal prevention programmes are a useful element of the prevention portfolio as they allow us to tackle elements of the social environment that are known to be risk factors for EDs, such as perceived pressure from peers towards thinness. 78,79 Universal interventions also do not face some of the difficulties of selective programmes, namely the stigma associated with participating and the low uptake of those identified as being at risk.…”

Section: Introductionmentioning

confidence: 99%

“…72,272,273 There are high levels of physical disability and psychological comorbidity and the median duration of AN is 6 years. 274 Although for most patients with AN the treatment of choice is outpatient psychological therapy, a proportion of cases with severe and potentially life-threatening illness need skilled refeeding in hospital.…”

Section: Introductionmentioning

confidence: 99%

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Treatment of anorexia nervosa: a multimethod investigation translating experimental neuroscience into clinical practice

Schmidt

Sharpe

Bartholdy

et al. 2017

Programme Grants Appl Res

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BackgroundAnorexia nervosa (AN) is a severe psychiatric condition and evidence on how to best treat it is limited.ObjectivesThis programme consists of seven integrated work packages (WPs) and aims to develop and test disseminable and cost-effective treatments to optimise management for people with AN across all stages of illness.MethodsWP1a used surveys, focus groups and a pre–post trial to develop and evaluate a training programme for school staff on eating disorders (EDs). WP1b used a randomised controlled trial (RCT) [International Standard Randomised Controlled Trial Number (ISRCTN) 42594993] to evaluate a prevention programme for EDs in schools. WP2a evaluated an inpatient treatment for AN using case reports, interviews and a quasi-experimental trial. WP2b used a RCT (ISRCTN67720902) to evaluate two outpatient psychological therapies for AN. WP3 used a RCT (ISRCTN06149665) to evaluate an intervention for carers of inpatients with AN. WP4 used actimetry, self-report and endocrine assessment to examine physical activity (PA) in AN. WP5 conducted a RCT (ISRCTN18274621) of an e-mail-guided relapse prevention programme for inpatients with AN. WP6 analysed cohort data to examine the effects of maternal EDs on fertility and their children’s diet and growth. WP7a examined clinical case notes to explore how access to specialist ED services affects care pathways and user experiences. Finally, WP7b used data from this programme and the British Cohort Study (1970) to identify the costs of services used by people with AN and to estimate annual costs of AN for England.ResultsWP1a: a brief training programme improved knowledge, attitudes and confidence of school staff in managing EDs in school. WP1b: a teacher-delivered intervention was feasible and improved risk factors for EDs in adolescent girls. WP2a: both psychological therapies improved outcomes in outpatients with AN similarly, but patients preferred one of the treatments. WP2b: the inpatient treatment (Cognitive Remediation and Emotional Skills Training) was acceptable with perceived benefits by patients, but showed no benefits compared with treatment as usual (TAU). WP3: compared with TAU, the carer intervention improved a range of patient and carer outcomes, including carer burden and patient ED symptomatology. WP4: drive to exercise is tied to ED pathology and a desire to improve mood in AN patients. PA was not increased in these patients. WP5: compared with TAU, the e-mail-guided relapse prevention programme resulted in higher body mass index and lower distress in patients at 12 months after discharge. WP6: women with an ED had impaired fertility and their children had altered dietary and growth patterns compared with the children of women without an ED. WP7a: direct access to specialist ED services was associated with higher referral rates, lower admission rates, greater consistency of care and user satisfaction. WP7b: the annual costs of AN in England are estimated at between £45M and £230M for 2011.ConclusionsThis programme has produced evidence to inform future intervention development and has developed interventions that can be disseminated to improve outcomes for individuals with AN. Directions for future research include RCTs with longer-term outcomes and sufficient power to examine mediators and moderators of change.Trial registrationCurrent Controlled Trials ISRCTN42594993, ISRCTN67720902, ISRCTN06149665 and ISRCTN18274621.FundingThis project was funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research programme and will be published in full inProgramme Grants for Applied Research; Vol. 5, No. 16. See the NIHR Journals Library website for further project information.

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Section: Harmsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Treatment of anorexia nervosa: a multimethod investigation translating experimental neuroscience into clinical practice

Schmidt

Sharpe

Bartholdy

et al. 2017

Programme Grants Appl Res

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“…Over the last years, the incidence of anorexia increased significantly in this high-risk group, although the overall incidence rate remained stable [3,4,5]. Anorexia is a very serious and even life-threatening psychiatric illness with a mortality rate of 5 to 6%, higher than all other mental disorders [6,7,8].…”

Section: Introductionmentioning

confidence: 97%

Risks and threats of social media websites: Twitter and the pro-Ana movement

Camussi

Bert

Gualano

et al. 2015

European Journal of Public Health

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1 Questa è la versione pre-print (prima bozza) dell'articolo "Risks and threats of social media websites: Twitter and the pro-Ana movement" degli autori Bert F, Gualano MR, Camussi E, Siliquini R., pubblicato come Original Paper sulla rivista Cyberpsychology, behaviors and social networking. AcknoledgmentsThe authors declare that they have not received grants or funding for this work. Conflict of InterestThe authors declare that they have no competing interests. Background:In recent years,there was a spread of "pro-anorexia" websites.

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“…Anorexia nervosa is a disease of a persistent character and a diversified course; it is also fraught with a high risk of death. It has been estimated that mortality indices among anorectic patients are at least 5 times higher than expected [2,3,8,9].…”

mentioning

confidence: 95%