Krug Isabel, Liu Shanshan, Portingale Jade, Croce Sarah, Dar Beya, Obleada Katrina, Satheesh Veena, Wong Meila, Fuller-Tyszkiewicz Matthew
Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia.
Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia; School of Medicine and Psychology, The Australian National University, ACT, Australia.
Clin Psychol Rev. 2025 Mar;116:102547. doi: 10.1016/j.cpr.2025.102547. Epub 2025 Jan 12.
Elevated mortality rates have been reported in individuals with eating disorders (EDs). However, no meta-analysis in the past decade has provided an updated, comprehensive synthesis of mortality across all ED diagnoses while exploring potential moderating factors. We conducted a systematic search in four databases (PsycINFO, MEDLINE, Embase and Web of Science) from 2010 to 29 Oct 2024. Studies that reported standardized mortality ratios (SMRs) in individuals with a diagnosed ED (including formal diagnoses and self-reports) were included. Random-effects meta-analyses were conducted to pool estimates across studies. Meta-regression was conducted to examine predictors of heterogeneity. Meta-analysis of SMRs of effect sizes revealed elevated mortality risk for individuals with an ED (regardless of ED subtype); weighted SMR = 3.39 (95 % CIs: 2.90, 3.95), p < .001, I = 95.1 %, Q = 1492.39, p < .001. SMRs were highest for individuals with anorexia nervosa (5.21; k = 30), followed by eating disorder not otherwise specified (2.51; k = 8); bulimia nervisa (2.20; k = 18) and binge eating disorder (1.46; k = 3). Individuals with EDs demonstrate markedly heightened mortality rates, especially among those with anorexia nervosa. Our findings are crucial for identifying key factors influencing mortality in EDs, guiding targeted interventions to reduce preventable deaths.
据报道，饮食失调（ED）患者的死亡率有所上升。然而，在过去十年中，没有一项荟萃分析能在探索潜在调节因素的同时，对所有饮食失调诊断的死亡率进行更新的、全面的综合分析。我们在2010年至2024年10月29日期间对四个数据库（PsycINFO、MEDLINE、Embase和Web of Science）进行了系统检索。纳入了报告已确诊饮食失调个体（包括正式诊断和自我报告）标准化死亡率（SMR）的研究。进行随机效应荟萃分析以汇总各研究的估计值。进行元回归以检查异质性的预测因素。效应量的SMR荟萃分析显示，饮食失调个体（无论饮食失调亚型如何）的死亡风险升高；加权SMR = 3.39（95%置信区间：2.90，3.95），p <.001，I = 95.1%，Q = 1492.39，p <.001。神经性厌食症患者的SMR最高（5.21；k = 30），其次是未另行指定的饮食失调（2.51；k = 8）；神经性贪食症（2.20；k = 18）和暴饮暴食症（1.46；k = 3）。饮食失调个体的死亡率明显升高，尤其是神经性厌食症患者。我们的研究结果对于确定影响饮食失调死亡率的关键因素、指导有针对性的干预措施以减少可预防的死亡至关重要。
