An audit of a British sample of death certificates in which anorexia nervosa is listed as a cause of death.
OBJECTIVE
Anorexia nervosa is associated with an increased mortality rate. National mortality statistics based on statutory death certification are potentially an important source of information. However, there are reasons to believe that these statistics may be subject to significant errors. An audit of the quality of information and diagnosis was conducted on death certificates in which anorexia nervosa was mentioned.


METHODS
The current study examined data from death certificates of people who died in England and Wales between 1993 and 1999.


RESULTS
There were 230 such deaths, but only 128--just over one half--were rated as likely to be deaths associated with true anorexia nervosa.


CONCLUSIONS
National mortality statistics derived from death certificates are a flawed source of information on deaths from anorexia nervosa when taken at face value. There may be both underreporting and overreporting. Detailed examination may improve their usefulness by reducing the overerreporting. It seems likely that the association of deaths with anorexia nervosa is systematically underreported.
South Warwickshire Primary Care Trust, St Michael's Hospital, Warwick CV34 5QW, UK. anne@muirmursell.fsnet.co.uk
Anne
A
Muir
Robert L
RL
Palmer
D000328:Adult; D000856:Anorexia Nervosa / Q000453:epidemiology / Q000401:mortality*; D003644:Death Certificates; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D012042:Registries; D006113:United Kingdom / Q000453:epidemiology