Faculty Opinions recommendation of Excess mortality, causes of death and prognostic factors in anorexia nervosa.

2009 ◽  
Author(s):  
Guido Frank
Keyword(s):  
Anorexia Nervosa ◽  
Prognostic Factors ◽  
Causes Of Death ◽  
Excess Mortality ◽  
Mortality Causes

scholarly journals Excess mortality, causes of death and prognostic factors in anorexia nervosa

2009 ◽  
Vol 194 (1) ◽  
pp. 10-17 ◽  
Author(s):  
Fotios C. Papadopoulos ◽  
Anders Ekbom ◽  
Lena Brandt ◽  
Lisa Ekselius
Keyword(s):  
Anorexia Nervosa ◽  
Prognostic Factors ◽  
Causes Of Death ◽  
Patient Treatment ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Somatic Comorbidity ◽  
Assessment And Treatment ◽  
Mortality Causes ◽  
Almost All

BackgroundAnorexia nervosa is a mental disorder with high mortality.AimsTo estimate standardised mortality ratios (SMRs) and to investigate potential prognostic factors.MethodSix thousand and nine women who had in-patient treatment for anorexia nervosa were followed-up retrospectively using Swedish registers.ResultsThe overall SMR for anorexia nervosa was 6.2 (95% CI 5.5– 7.0). Anorexia nervosa, psychoactive substance use and suicide had the highest SMR. The SMR was significantly increased for almost all natural and unnatural causes of death. The SMR 20 years or more after the first hospitalisation remained significantly high. Lower mortality was found during the last two decades. Younger age and longer hospital stay at first hospitalisation was associated with better outcome, and psychiatric and somatic comorbidity worsened the outcome.ConclusionsAnorexia nervosa is characterised by high lifetime mortality from both natural and unnatural causes. Assessment and treatment of psychiatric comorbidity, especially alcohol misuse, may be a pathway to better long-term outcome.

Anorexia nervosa in males: excess mortality and psychiatric co-morbidity in 609 Swedish in-patients

2017 ◽  
Vol 47 (8) ◽  
pp. 1489-1499 ◽  
Author(s):  
J. Kask ◽  
M. Ramklint ◽  
N. Kolia ◽  
D. Panagiotakos ◽  
A. Ekbom ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Causes Of Death ◽  
Excess Mortality ◽  
Cox Regression ◽  
Somatoform Disorders ◽  
Psychiatric Diagnoses ◽  
Co Morbidity ◽  
Significant Difference

BackgroundAnorexia nervosa (AN) is a psychiatric disorder with high mortality.MethodA retrospective register study of 609 males who received hospitalized care for AN in Sweden between 1973 and 2010 was performed. The standardized mortality ratios (SMRs) and Cox regression-derived hazard ratios (HRs) were calculated as measures of mortality. The incidence rate ratios (IRRs) were calculated to compare the mortality rates in patients with AN and controls both with and without psychiatric diagnoses.ResultsThe SMR for all causes of death was 4.1 [95% confidence interval (CI) 3.1–5.3]. For those patients with psychiatric co-morbidities, the SMR for all causes of death was 9.1 (95% CI 6.6–12.2), and for those without psychiatric co-morbidity, the SMR was 1.6 (95% CI 0.9–2.7). For the group of patients with alcohol use disorder, the SMR for natural causes of death was 11.5 (95% CI 5.0–22.7), and that for unnatural causes was 35.5 (95% CI 17.7–63.5). The HRs confirmed the increased mortality for AN patients with psychiatric co-morbidities, even after adjusting for confounders. The IRRs revealed no significant difference in mortality patterns between the AN patients with psychiatric co-morbidity and the controls with psychiatric diagnoses, with the exceptions of alcohol use disorder and neurotic, stress-related and somatoform disorders, which seemed to confer a negative synergistic effect on mortality.ConclusionMortality in male AN patients was significantly elevated compared with the general population among only the patients with psychiatric co-morbidities. Specifically, the presence of alcohol and other substance use disorders was associated with more profound excess mortality.

scholarly journals Excess Mortality, Causes of Death and Life Expectancy in 270,770 Patients with Recent Onset of Mental Disorders in Denmark, Finland and Sweden

PLoS ONE ◽  
2013 ◽  
Vol 8 (1) ◽  
pp. e55176 ◽  
Author(s):  
Merete Nordentoft ◽  
Kristian Wahlbeck ◽  
Jonas Hällgren ◽  
Jeanette Westman ◽  
Urban Ösby ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Life Expectancy ◽  
Causes Of Death ◽  
Excess Mortality ◽  
Recent Onset ◽  
Mortality Causes

Prognostic Factors in Anorexia nervosa

1988 ◽  
Vol 49 (3-4) ◽  
pp. 137-144 ◽  
Author(s):  
Klaus Engel
Keyword(s):  
Anorexia Nervosa ◽  
Prognostic Factors

scholarly journals THE US MIDLIFE MORTALITY CRISIS CONTINUES: INCREASED DEATH RATES FROM CAUSES OTHER THAN COVID-19 DURING 2020

2021 ◽  
Author(s):  
Dana A Glei
Keyword(s):  
Indirect Effect ◽  
Causes Of Death ◽  
Excess Mortality ◽  
Negative Binomial ◽  
National Level ◽  
Age Groups ◽  
Negative Binomial Regression ◽  
Negative Binomial Regression Model ◽  
Age Group ◽  
External Causes

COVID-19 has prematurely ended many lives, particularly among the oldest Americans, but the pandemic has also had an indirect effect on health and non-COVID mortality among the working-age population, who have suffered the brunt of the economic consequences. This analysis quantifies the changes in mortality for selected causes of death during the COVID 19 pandemic up to December 31, 2020, and investigates whether the levels of excess mortality varied by age group. The data comprise national-level monthly death counts by age group and selected causes of death from January 1999 to December 2020 combined with annual mid-year population estimates over the same period. A negative binomial regression model was used to estimate monthly cause-specific excess mortality during 2020 controlling for the pre-pandemic mortality patterns by age, calendar year, and season. To determine whether excess mortality varied by age, we tested interactions between broad age groups and dichotomous indicators for the pre-pandemic (January-February) and the pandemic (March-December) portions of 2020. In relative terms, excess all cause mortality (including COVID-19) peaked in December at ages 25-44 (RR=1.58 relative to 2019, 95% CI=1.50-1.68). Excluding COVID-19, all of the excess mortality occurred between ages 15 and 64, peaking in July among those aged 25-44 (RR=1.45, 95% CI 1.37-1.53). We find notable excess mortality during March-December 2020 for many causes (i.e., influenza/pneumonia, other respiratory diseases, diabetes, heart disease, cerebrovascular disease, kidney disease, and external causes), but almost exclusively among young and midlife (aged 25-74) Americans. For those aged 75 and older, there was little excess mortality from causes other than COVID-19 except from Alzheimer's disease. Excess non-COVID mortality may have resulted, at least partly, from incorrectly classified COVID-19 deaths, but neither misclassification nor an atypical flu season that disproportionately affected younger people is likely to explain the increase in mortality from external causes, which was evident even during January-February 2020. Exploratory analyses suggest that drug-related mortality may be driving the early rise in external mortality. The growth in drug overdoses well before there was any hint of a pandemic suggests it is probably not solely an indirect effect of COVID-19, although the pandemic may have exacerbated the problem.

scholarly journals Pneumococcal sepsis associated with adrenal apoplexy in a young woman with anorexia nervosa

2013 ◽  
pp. 25-29
Author(s):  
Nicola Maria Vitola ◽  
Dante Lo Pardo ◽  
Romualdo Cirillo ◽  
Matteo De Roberto ◽  
Pier Giovanni Crocco ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Emergency Department ◽  
Anorexia Nervosa ◽  
Sudden Death ◽  
Clinical Picture ◽  
Causes Of Death ◽  
Critical Conditions ◽  
Crude Rate ◽  
Treatment Practices ◽  
Pneumococcal Sepsis

BACKGROUND A crude rate of mortality of 5% has been quoted for anorexia nervosa in recent studies. Nowadays the mechanism of death is unclear and various authors recommend that any anorexia nervosa death be reported and that, where possible, an autopsy be performed. METHODS In this work we present a case of sudden death in anorexia nervosa with unexpected autopsy findings. A 21-years-old woman with long-standing anorexia nervosa, severely underweight with a body mass index of 14.47 kg/m2, has been taken to the Emergency Department in very critical conditions. Despite the attempts of resuscitation, she died shortly afterwards. Therefore an autopsy has been requested in order to clarify the causes of death. RESULTS The clinical picture, laboratory parameters, histology and microbiological investigations were consistent with pneumococcal sepsis associated adrenal apoplexy. CONCLUSIONS The cause of death in anorexia nervosa cannot reliably be established from antemortem clinical features. All anorexia nervosa deaths should be reported together with description of necropsy. This may lead to advances in the knowledge and treatment practices.

scholarly journals EXCESS MORTALITY FROM COVID-19. WEEKLY EXCESS DEATH RATES BY AGE AND SEX FOR SWEDEN AND ITS MOST AFFECTED REGION

2020 ◽  
Author(s):  
Karin Modig ◽  
Anders Ahlbom ◽  
Marcus Ebeling
Keyword(s):  
Causes Of Death ◽  
Excess Mortality ◽  
National Level ◽  
Mortality Rates ◽  
Regional Level ◽  
Death Rates ◽  
Excess Death ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Age And Sex

Abstract Background Sweden has one of the highest numbers of COVID-19 deaths per inhabitant globally. However, absolute death counts can be misleading. Estimating age- and sex-specific mortality rates is necessary in order to account for the underlying population structure. Furthermore, given the difficulty of assigning causes of death, excess all-cause mortality should be estimated to assess the overall burden of the pandemic. Methods By estimating weekly age- and sex-specific death rates during 2020 and during the preceding five years, our aim is to get more accurate estimates of the excess mortality attributed to COVID-19 in Sweden, and in the most affected region Stockholm. Results Eight weeks after Sweden’s first confirmed case, the death rates at all ages above 60 were higher than for previous years. Persons above age 80 were disproportionally more affected, and men suffered greater excess mortality than women in ages up to 75 years. At older ages, the excess mortality was similar for men and women, with up to 1.5 times higher death rates for Sweden and up to 3 times higher for Stockholm. Life expectancy at age 50 declined by less than 1 year for Sweden and 1.5 years for Stockholm compared to 2019. Conclusions The excess mortality has been high in older ages during the pandemic, but it remains to be answered if this is because of age itself being a prognostic factor or a proxy for comorbidity. Only monitoring deaths at a national level may hide the effect of the pandemic on the regional level.

scholarly journals Adolescent psychiatric in-patients

2000 ◽  
Vol 176 (2) ◽  
pp. 121-125 ◽  
Author(s):  
Ellen Kjelsberg
Keyword(s):  
Anxiety Disorder ◽  
Mental Disorder ◽  
Record Linkage ◽  
Causes Of Death ◽  
Excess Mortality ◽  
Mortality Rates ◽  
Psychiatric Diagnoses ◽  
Organic Mental Disorder ◽  
Standardised Mortality Ratios ◽  
Almost All

BackgroundResearch has demonstrated increased mortality rates in adolescent psychiatric in-patients.AimsTo investigate this excess mortality by calculating standardised mortality ratios (SMRs) relative to cause of death, diagnosis, cohort and age.MethodA nationwide Norwegian sample of 1095 former adolescent psychiatric in-patients were followed up 15–33 years after first hospitalisation by record linkage to the National Death Cause Registry.ResultsThe SMR was significantly increased for almost all causes of death investigated. In males, all psychiatric diagnoses had significantly increased SMRs, whereas in females, organic mental disorder, anxiety disorder and affective disorder had non-significantly increased SMRs. The SMR was significantly elevated for all age-spans and cohorts investigated.ConclusionsA broad prevention strategy is needed to combat the increased mortality rates found in adolescent psychiatric in-patients.

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