Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Department of Psychiatry, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
Int J Eat Disord. 2023 Jun;56(6):1135-1144. doi: 10.1002/eat.23934. Epub 2023 Mar 14.
To investigate natural- and unnatural-cause mortality at different follow-up time points in Taiwanese patients with anorexia nervosa (AN) and bulimia nervosa (BN).
In this longitudinal cohort study, 330,393 patients, including 2143 patients with AN, 13,590 with BN, and 20 times as many respective non-AN and non-BN patients, were followed up for 16 years. We performed conditional Cox regression survival analysis to examine the risk of mortality in the AN and BN groups relative to the comparison group.
A total of 1242 patients died, including 101 and 343 patients with AN and BN, respectively. Mortality rates for AN and BN were 5.42 and 2.90 deaths per 1000 person-years, respectively. Compared with the non-AN group, the AN group had a significantly higher risk of both natural- and unnatural-cause mortality, and the BN group had a significantly higher risk of unnatural-cause mortality. Suicide was the most common cause of death, and suicide risk was significantly higher in both the AN and BN groups. All-cause mortality risk was the highest at the beginning of follow-up and markedly declined in the AN group. In the BN group, all-cause mortality risk was lower but stable at follow-up. The risk of unnatural-cause mortality remained high throughout the follow-up period for both the groups.
Early detection and treatment for associated physical problems in patients with AN are crucial. Regular monitoring for unnatural-cause mortality events (mainly suicide) in AN and BN over time is also crucial.
AN had a significantly higher risk of both natural- and unnatural-cause mortality and BN had a significantly higher risk of death from unnatural causes. All-cause mortality risk was highest at the beginning of follow-up in AN, but unnatural-cause mortality risk remained high throughout the follow-up period for both groups. Our findings imply that early detection and treatment in AN and regular monitoring for unnatural-cause mortality events in AN and BN are crucial.
调查台湾地区神经性厌食症（AN）和神经性贪食症（BN）患者在不同随访时间点的自然和非自然原因死亡率。
在这项纵向队列研究中，对 330393 名患者进行了随访，包括 2143 名 AN 患者、13590 名 BN 患者和 20 倍的相应非 AN 和非 BN 患者，随访时间为 16 年。我们进行了条件 Cox 回归生存分析，以检查 AN 和 BN 组相对于对照组的死亡率风险。
共有 1242 名患者死亡，其中 AN 组和 BN 组分别为 101 名和 343 名。AN 和 BN 的死亡率分别为每 1000 人年 5.42 例和 2.90 例。与非 AN 组相比，AN 组的自然和非自然原因死亡率均显著升高，BN 组的非自然原因死亡率显著升高。自杀是最常见的死亡原因，AN 和 BN 组的自杀风险均显著升高。所有原因死亡率风险在随访开始时最高，在 AN 组中显著下降。在 BN 组中，所有原因死亡率风险较低，但在随访期间保持稳定。两组的非自然原因死亡率风险在整个随访期间均保持较高水平。
早期发现和治疗 AN 患者的相关身体问题至关重要。随着时间的推移，定期监测 AN 和 BN 患者的非自然原因死亡事件（主要是自杀）也至关重要。
AN 患者的自然和非自然原因死亡率均显著升高，BN 患者的非自然原因死亡率显著升高。AN 组在随访开始时的全因死亡率风险最高，但两组的非自然原因死亡率风险在整个随访期间均保持较高水平。我们的研究结果表明，早期发现和治疗 AN 以及定期监测 AN 和 BN 的非自然原因死亡事件至关重要。
