Department of Psychiatry, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada.
Mathison Centre for Mental Health Research & Education, Foothills Medical Centre, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6, Canada.
Nutrients. 2021 Sep 23;13(10):3333. doi: 10.3390/nu13103333.
Eating disorders (EDs) are often reported to have the highest mortality of any mental health disorder. However, this assertion is based on clinical samples, which may provide an inaccurate view of the actual risks in the population. Hence, in the current retrospective cohort study, mortality of self-reported lifetime history of EDs in the general population was explored. The data source was the Canadian Community Health Survey: Mental Health and Well-Being (CCHS 1.2), linked to a national mortality database. The survey sample was representative of the Canadian household population (mean age = 43.95 years, 50.9% female). The survey inquired about the history of professionally diagnosed chronic conditions, including EDs. Subsequently, the survey dataset was linked to the national mortality dataset (for the date of death) up to 2017. Cox proportional hazards models were used to explore the effect of EDs on mortality. The unadjusted-hazard ratio (HR) for the lifetime history of an ED was 1.35 (95% CI 0.70-2.58). However, the age/sex-adjusted HR increased to 4.5 (95% CI 2.33-8.84), which was over two times higher than age/sex-adjusted HRs for other mental disorders (schizophrenia/psychosis, mood-disorders, and post-traumatic stress disorder). In conclusion, all-cause mortality of self-reported lifetime history of EDs in the household population was markedly elevated and considerably higher than that of other self-reported disorders. This finding replicates prior findings in a population-representative sample and provides a definitive quantification of increased risk of mortality in EDs, which was previously lacking. Furthermore, it highlights the seriousness of EDs and an urgent need for strategies that may help to improve long-term outcomes.
进食障碍（EDs）通常被报道为所有精神健康障碍中死亡率最高的疾病。然而，这一说法是基于临床样本得出的，可能无法准确反映人群中的实际风险。因此，在目前这项回顾性队列研究中，我们探讨了一般人群中自我报告的终生进食障碍史的死亡率。数据来源是加拿大社区健康调查：心理健康与幸福感（CCHS 1.2），与国家死亡率数据库相关联。调查样本代表了加拿大的家庭人口（平均年龄为 43.95 岁，女性占 50.9%）。该调查询问了包括 ED 在内的经专业诊断的慢性疾病的病史。随后，将调查数据集与国家死亡率数据集（截至 2017 年的死亡日期）进行了链接。使用 Cox 比例风险模型来探讨 ED 对死亡率的影响。未调整的风险比（HR）终生进食障碍史为 1.35（95%CI 0.70-2.58）。然而，年龄/性别调整后的 HR 增加到 4.5（95%CI 2.33-8.84），这比年龄/性别调整后的其他精神障碍（精神分裂症/精神病、情绪障碍和创伤后应激障碍）的 HR 高两倍多。总之，在家庭人群中，自我报告的终生进食障碍史的全因死亡率明显升高，明显高于其他自我报告的障碍。这一发现复制了在代表性人群样本中的先前发现，并对 ED 中死亡率增加的风险进行了明确的量化，而之前这方面的研究是缺乏的。此外，它强调了 ED 的严重性以及迫切需要采取策略来改善长期结局。
