Mortality and predictors of death in a cohort of patients presenting to an eating disorders service.

OBJECTIVE

The main aim was to investigate mortality across the spectrum of eating disorders presenting to a specialized service for adults in the UK. A secondary aim was to explore whether any clinical and demographic factors may be associated with increased risk.

METHOD: We conducted a "tracing" study of 1,892 patients assessed by the Service between 1992 and 2004. We used the Office of National Statistics to identify all deaths recorded up to August 2007. We also compared deceased patients with matched controls in terms of a number of clinical and demographic variables at initial presentation to the service.

RESULTS

Anorexia nervosa had a ten-fold increased risk of early death, but there was also evidence of increased risk in other groups of patients, including eating disorder not otherwise specified. A number of clinical factors predicted increased mortality risk, especially very low body mass index and the presence of alcohol misuse.

DISCUSSION: The study confirms previous evidence of a markedly increased mortality risk for anorexia nervosa, but also suggests that the risk is not confined to this eating disorder and that greater attention needs to be focused on wider psychiatric comorbidity.