Department of Psychiatry, Helsinki University Central Hospital, Finland; Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland.
Psychiatry Res. 2013 Dec 30;210(3):1101-6. doi: 10.1016/j.psychres.2013.07.042. Epub 2013 Aug 17.
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.
神经性厌食症患者的死亡率已经确定，但关于神经性贪食症和暴食障碍患者的结局则知之甚少。在这项随访研究中，我们确定了在 1995 年至 2010 年期间，在赫尔辛基大学中心医院的饮食失调诊所住院的成年人（N=2450，95%为女性）的死亡率。大多数患者（80.7%）为门诊患者。为每位患者选择了 4 名对照，并按年龄、性别和居住地进行匹配。通过 Cox 比例风险模型对终点事件进行建模，考虑了匹配。所有原因死亡率的风险比（HR）在广泛的神经性厌食症（AN）中为 6.51（95%CI 3.46-12.26），在广泛的神经性贪食症（BN）中为 2.97（95%CI 1.90-4.65），在暴食障碍（BED）中为 1.77（95%CI 0.60-5.27）。广泛 AN 的死亡率在入院后最初几年最高，但此后有所下降，而广泛 BN 的死亡率在首次入院后两年开始上升。自杀的 HR 在广泛 AN（HR 5.07；95%CI 1.37-18.84）和广泛 BN（HR 6.07；95%CI 2.47-14.89）中均升高。结果表明，即使提供了专门的治疗，饮食失调症也与死亡率风险增加有关。
