Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy.
Psychiatry Unit, Careggi University Hospital, Florence, Italy.
Acta Psychiatr Scand. 2023 Feb;147(2):122-133. doi: 10.1111/acps.13487. Epub 2022 Aug 12.
Eating disorders (EDs) are considered serious mental illnesses, with one of the highest lethality among psychiatric disorders, even though the issue of mortality due to these conditions is still controversial. The present study was aimed at comparing the mortality rate in a cohort of ED patients representative of the geographic area with that of the age and gender-matched general population of central Italy.
Patients were enrolled between 1994 and 2018, among those attending the eating disorders treatment network of the Florence area (EDTN), which is a regional multidisciplinary treatment reference center for EDs covering the clinical population of the metropolitan Florence area (Italy). The life status of participants was determined through linkage with the Regional Mortality Registry.
A total of 1277 individuals with EDs were included, including 368 with Anorexia Nervosa (AN), 312 with Bulimia Nervosa (BN), and 597 individuals with Binge Eating Disorder (BED). Twenty-two patients (1.72%) died, during a median follow-up of 7.4 years. The mortality rates among ED patients did not significantly differ from that of the general population of the same age and sex with a Standardized Mortality Ratio (SMR) of 1.19, 95% CI 0.79-1.81. Only among BN patients, the mortality was significantly increased after 10 years from clinical evaluation (SMR 11.24, 95% CI 3.62-34.84).
The low mortality in EDs, compared to published studies, might be due to the EDTN treatment strategy, based on a large network which makes an integrated multidisciplinary team available for almost all the patients with EDs of the geographical area.
饮食失调（EDs）被认为是严重的精神疾病，在精神疾病中死亡率最高，尽管这些疾病导致的死亡率问题仍存在争议。本研究旨在比较一个代表该地理区域的 ED 患者队列的死亡率与意大利中部年龄和性别匹配的一般人群的死亡率。
患者于 1994 年至 2018 年期间在佛罗伦萨地区的饮食失调治疗网络（EDTN）中接受治疗，EDTN 是一个区域多学科 ED 治疗参考中心，覆盖了意大利佛罗伦萨大都市区的临床人群。通过与区域死亡率登记处的联系确定参与者的生存状况。
共纳入 1277 名 ED 患者，包括 368 名神经性厌食症（AN）患者、312 名神经性贪食症（BN）患者和 597 名暴食障碍（BED）患者。22 名患者（1.72%）死亡，中位随访时间为 7.4 年。ED 患者的死亡率与相同年龄和性别的一般人群无显著差异，标准化死亡率比（SMR）为 1.19，95%置信区间（CI）为 0.79-1.81。仅在 BN 患者中，在临床评估后 10 年死亡率显著增加（SMR 11.24，95%CI 3.62-34.84）。
与已发表的研究相比，EDs 的低死亡率可能归因于 EDTN 的治疗策略，该策略基于一个大型网络，为该地理区域的几乎所有 ED 患者提供了一个综合的多学科团队。
