Inserm, U669, Paris, France.
Eur Eat Disord Rev. 2013 Jan;21(1):15-9. doi: 10.1002/erv.2178. Epub 2012 Apr 23.
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.
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.
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.
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.
暴食症（BN）患者，尤其是病情最严重的患者，其死亡率仍不明确。本研究旨在增进对 BN 和死亡率的认识。
本研究纳入了 258 名 BN（《精神疾病诊断与统计手册》第四版）连续住院患者，这些患者于入院时进行了初始评估（1988-2004 年）。采用法国国家登记处来确定存活状态。对假设的死亡预测因素进行标准化死亡率（SMR）计算和双变量 Cox 分析。
平均随访时间为 10.5 年。记录到 10 例死亡，粗死亡率为 3.9%；SMR=5.52[95%CI（2.64-10.15）]。大多数死亡是自杀导致的[6/10，SMR=30.9（5.7-68.7）]。死亡时的平均年龄为 29.6 岁。预测因素为既往自杀未遂和最低 BMI 较低。
严重 BN 患者的死亡风险（主要是自杀）更高，尤其是有既往自杀未遂或既往 BMI 较低的患者。需要进一步研究来证实这些结果。
