title: Mortality and its predictors in severe bulimia nervosa patients.
abstract: BACKGROUND
  The risk of mortality remains unclear for bulimia nervosa (BN) patients, especially the most severe. The aims of this study were to improve knowledge on BN and mortality.
  
  
  METHODS
  With initial evaluation at admission, 258 BN (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) consecutive inpatients were included (1988-2004). Vital status was established from the French national register. Standardized Mortality Ratio (SMR) calculation and bivariate Cox analysis were performed for the hypothesised predictors of mortality.
  
  
  RESULTS
  Mean follow-up duration was 10.5 years. Ten deaths were recorded, and the crude mortality ratio was 3.9%; SMR = 5.52 [CI95 (2.64-10.15)]. The majority of deaths were from suicide [6/10, SMR = 30.9 (5.7-68.7)]. The mean age at time of death was 29.6 years. Predictive factors were previous suicide attempt and low minimum BMI.
  
  
  CONCLUSIONS
  Severe BN patients are at higher risk of death (mainly suicide) especially if previous suicide attempt or previous low BMI. More studies are needed to confirm these results.
authors.affiliation: Inserm, U669, Paris, France. carohuas@gmail.com
authors.forename: Caroline
authors.initials: C
authors.lastname: Huas
authors.forename: Nathalie
authors.initials: N
authors.lastname: Godart
authors.forename: Agnès
authors.initials: A
authors.lastname: Caille
authors.forename: Alexandra
authors.initials: A
authors.lastname: Pham-Scottez
authors.forename: Christine
authors.initials: C
authors.lastname: Foulon
authors.forename: Snezana M
authors.initials: SM
authors.lastname: Divac
authors.forename: Guillaume
authors.initials: G
authors.lastname: Lavoisy
authors.forename: Julien-Daniel
authors.initials: JD
authors.lastname: Guelfi
authors.forename: Bruno
authors.initials: B
authors.lastname: Falissard
authors.forename: Frédéric
authors.initials: F
authors.lastname: Rouillon
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D052018:Bulimia Nervosa / Q000401:mortality*; D002423:Cause of Death; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013405:Suicide / Q000706:statistics & numerical data*; D013406:Suicide, Attempted / Q000706:statistics & numerical data*; D055815:Young Adult