Excess mortality, causes of death and prognostic factors in anorexia nervosa.
Open accessAbstract
Background: Anorexia nervosa is a mental disorder with high mortality. Aims: To estimate standardised mortality ratios (SMRs) and to investigate potential prognostic factors. Method: Six thousand and nine women who had in-patient treatment for anorexia nervosa were followed-up retrospectively using Swedish registers. Results: The overall SMR for anorexia nervosa was 6.2 (95% CI 5.5– 7.0). Anorexia nervosa, psychoactive substance use and suicide had the highest SMR. The SMR was significantly increased for almost all natural and unnatural causes of death. The SMR 20 years or more after the first hospitalisation remained significantly high. Lower mortality was found during the last two decades. Younger age and longer hospital stay at first hospitalisation was associated with better outcome, and psychiatric and somatic comorbidity worsened the outcome. Conclusions: Anorexia nervosa is characterised by high lifetime mortality from both natural and unnatural causes. Assessment and treatment of psychiatric comorbidity, especially alcohol misuse, may be a pathway to better long-term outcome.
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Suicidality was more common among adolescents with bulimia nervosa compared with those with anorexia nervosa.
“Likewise, suicidality was more common among adolescents with BN compared with those with AN, corroborating findings from previous community surveys43 and some clinical studies.12–14”
From Prevalence and Correlates of Eating Disorders in Adolescents: Results From the National Comorbidity Survey Replication Adolescent Supplement (2011) · cites this paper as [13]
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- Authors
- Papadopoulos, F. C., Ekbom, A., Brandt, L., & Ekselius, L.
- Affiliations
- Uppsala University Hospital (SE)
- Karolinska University Hospital (SE)
- Corresponding author
- Papadopoulos, Fotios C.
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2009-01
- Volume
- 194
- Issue
- 1
- Pages
- 10-17
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2156759015
- Cited by
- 448
- References
- 49
- Citations by year
- 2026: 13 · 2025: 19 · 2024: 17 · 2023: 21 · 2022: 25 · 2021: 24 · 2020: 20 · 2019: 27 · 2018: 13 · 2017: 28 · 2016: 31 · 2015: 36 · 2014: 27 · 2013: 41 · 2012: 33
- FWCI
- 27.04
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Karolinska Institutet
- Vetenskapsrådet
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Keywords
- anorexia nervosa, excess mortality, standardized mortality ratio, causes of death, suicide, drug use, alcohol abuse, psychiatric comorbidity, somatic comorbidity, length of hospital stay, long-term outcomes, women
- MeSH terms
- Adolescent, Adult, Anorexia Nervosa, Mental Disorders, Cause of Death, Child, Female, Follow-Up Studies, Humans, Prognosis, Retrospective Studies, Sweden, Comorbidity, Age Distribution, Young Adult
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