title: Mortality in eating disorders: a follow-up study of adult eating disorder patients treated in tertiary care, 1995-2010.
abstract: Elevated mortality risk in anorexia nervosa has been established, but less is known about the outcomes of bulimia nervosa and binge eating disorder. In this follow-up study we determined mortality in adults (N=2450, 95% women) admitted to the eating disorder clinic of the Helsinki University Central Hospital in the period 1995-2010. Most of the patients (80.7%) were outpatients. For each patient four controls were selected and matched for age, sex and place of residence. The matching was taken into account by modelling end-point events using Cox's proportional hazard model. The hazard ratio (HR) for all-cause mortality was 6.51 (95% CI 3.46-12.26) in broad anorexia nervosa (AN), 2.97 (95% CI 1.90-4.65) in broad bulimia nervosa (BN), and 1.77 (95% CI 0.60-5.27) in binge eating disorder (BED). Mortality risk in broad AN was highest during the first years after admission but declined thereafter, while in broad BN the mortality risk started to rise two years after the first admission. The HR for suicide was elevated both in broad AN (HR 5.07; 95% CI 1.37-18.84) and in broad BN (HR 6.07; 95% CI 2.47-14.89). Results show that eating disorders are associated with increased mortality risk even when specialised treatment is available.
authors: Department of Psychiatry, Helsinki University Central Hospital, Finland; Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland. Electronic address: jaana.suokas@hus.fi.
authors: Jaana T
authors: JT
authors: Suokas
authors: Jaana M
authors: JM
authors: Suvisaari
authors: Mika
authors: M
authors: Gissler
authors: Rasmus
authors: R
authors: Löfman
authors: Milla S
authors: MS
authors: Linna
authors: Anu
authors: A
authors: Raevuori
authors: Jari
authors: J
authors: Haukka
mesh_terms: D000328:Adult; D000368:Aged; D000856:Anorexia Nervosa / Q000401:mortality / Q000523:psychology / Q000628:therapy; D056912:Binge-Eating Disorder / Q000401:mortality* / Q000523:psychology* / Q000628:therapy; D052018:Bulimia Nervosa / Q000401:mortality* / Q000523:psychology* / Q000628:therapy; D016022:Case-Control Studies; D002423:Cause of Death; D001068:Feeding and Eating Disorders / Q000401:mortality / Q000523:psychology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010045:Outpatients / Q000706:statistics & numerical data*; D011159:Population Surveillance; D016016:Proportional Hazards Models; D013405:Suicide / Q000706:statistics & numerical data*; D063128:Tertiary Health Care; D055815:Young Adult
keywords: Anorexia nervosa; Binge-eating disorder; Bulimia nervosa; Outpatient; Specialised eating disorder unit