Skip to main content

Advertisement

Log in

Impact of somatic severity on long-term mortality in anorexia nervosa

  • Original Article
  • Published:
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity Aims and scope Submit manuscript

Abstract

Purpose

Anorexia nervosa (AN) is a severe pathology on account of the high levels of associated morbidity and mortality. This study aimed to assess whether time in somatic intensive care unit, justified by a patient’s somatic condition in the course of hospital care, has any relationship with patient outcome in terms of mortality in the long term.

Methods

195 patients were hospitalised for AN between April 1996 and May 2002, 97 were re-assessed 9 years later on average.

Results

Out of 195 patients hospitalised for AN between April 1996 and May 2002, 29 had required transfer to intensive care. Mortality at 9 years was 20 times higher in the group having been transferred to intensive care, irrespective of the duration of follow-up.

Conclusion

The clinical seriousness of the somatic condition during hospitalisation for AN is a risk factor for excess mortality in the medium term.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Steinhausen HC (2009) Outcome of eating disorders. Child Adolesc Psychiatr Clin N Am 18(1):225–242. doi:10.1016/j.chc.2008.07.013

    Article  PubMed  Google Scholar 

  2. Hoek HW (2006) Incidence, prevalence and mortality of anorexia nervosa and other eating disorders. Curr Opin Psychiatry 19(4):389–394. doi:10.1097/01.yco.0000228759.95237.78

    Article  PubMed  Google Scholar 

  3. Berkman ND, Lohr KN, Bulik CM (2007) Outcomes of eating disorders: a systematic review of the literature. Int J Eat Disord 40(4):293–309. doi:10.1002/eat.20369

    Article  PubMed  Google Scholar 

  4. Steinhausen HC (2002) The outcome of anorexia nervosa in the 20th century. Am J Psychiatry 159(8):1284–1293

    Article  Google Scholar 

  5. Arcelus J, Mitchell AJ, Wales J, Nielsen S (2011) Mortality rates in patients with anorexia nervosa and other eating disorders. A meta-analysis of 36 studies. Arch Gen Psychiatry 68(7):724–731. doi:10.1001/archgenpsychiatry.2011.74

    Article  PubMed  Google Scholar 

  6. Ward A, Ramsay R, Russell G, Treasure J (2015) Follow-up mortality study of compulsorily treated patients with anorexia nervosa. Int J Eat Disord 48(7):860–865. doi:10.1002/eat.22377

    Article  PubMed  Google Scholar 

  7. Lindblad F, Lindberg L, Hjern A (2006) Improved survival in adolescent patients with anorexia nervosa: a comparison of two Swedish national cohorts of female in patients. Am J Psychiatry 163(8):1433–1435. doi:10.1176/appi.ajp.163.8.1433

    Article  PubMed  Google Scholar 

  8. Huas C, Caille A, Godart N, Foulon C, Pham-Scottez A, Divac S, Dechartres A, Lavoisy G, Guelfi JD, Rouillon F, Falissard B (2011) Factors predictive of ten-year mortality in severe anorexia nervosa patients. Acta Psychiatr Scand 123(1):62–70. doi:10.1111/j.1600-0447.2010.01627.x

    Article  CAS  PubMed  Google Scholar 

  9. Kask J, Ekselius L, Brandt L, Kollia N, Ekbom A, Papadopoulos FC (2016) Mortality in women with anorexia nervosa: the role of comorbid psychiatric disorders. Psychosom Med. doi:10.1097/psy.0000000000000342

    Article  PubMed  Google Scholar 

  10. Brown C, Mehler PS (2015) Medical complications of anorexia nervosa and their treatments: an update on some critical aspects. Eat Weight Disord 20(4):419–425. doi:10.1007/s40519-015-0202-3

    Article  PubMed  Google Scholar 

  11. Sachs KV, Harnke B, Mehler PS, Krantz MJ (2016) Cardiovascular complications of anorexia nervosa: a systematic review. Int J Eat Disord 49(3):238–248. doi:10.1002/eat.22481

    Article  PubMed  Google Scholar 

  12. Scanelli G, Gualandi M, Simoni M, Manzato E (2014) Somatic involvement assessed through a cumulative score of clinical severity in patients with eating disorders. Eat Weight Disord 19(1):49–59. doi:10.1007/s40519-013-0065-4

    Article  PubMed  Google Scholar 

  13. Tric LAG, Tran D, Godart N, Benmansour EL, Lamer C (2004) Management of anorexia nervosa in intensive care unit. Reanimation 13:407–4016

    Article  Google Scholar 

  14. O’Connor G, Nicholls D, Hudson L, Singhal A (2016) Refeeding low weight hospitalized adolescents with anorexia nervosa: a multicenter randomized controlled trial. Nutr Clin Pract. doi:10.1177/0884533615627267

    Article  PubMed  Google Scholar 

  15. Nakamura M, Yasunaga H, Shimada T, Horiguchi H, Matsuda S, Fushimi K (2013) Body mass index and in-hospital mortality in anorexia nervosa: data from the Japanese diagnosis procedure combination database. Eat Weight Disord 18(4):437–439. doi:10.1007/s40519-013-0051-x

    Article  PubMed  Google Scholar 

  16. Hebebrand J, Himmelmann GW, Heseker H, Schafer H, Remschmidt H (1996) Use of percentiles for the body mass index in anorexia nervosa: diagnostic, epidemiological, and therapeutic considerations. Int J Eat Disord 19(4):359–369. doi:10.1002/(SICI)1098-108X(199605)19:4<359:AID-EAT4>3.0.CO;2-K

    Article  CAS  Google Scholar 

  17. Godart N, Perdereau F, Gales O, Agman G, Deborde AS, Jeammet P (2005) The weight contract during the hospitalization of anorexic patients. Archives de pediatrie: organe officiel de la Societe francaise de pediatrie 12(10):1544–1550. doi:10.1016/j.arcped.2005.02.030

    Article  CAS  Google Scholar 

  18. Godart N, Atger F, Perdereau F, Agman G, Rein Z, Corcos M, Jeammet P (2004) Treatment of adolescent patients with eating disorders: description of a psychodynamic approach in clinical practice. Eat Weight Disord 9(3):224–227

    Article  CAS  Google Scholar 

  19. Godart N, Wallier J, Hubert T, Curt F, Gales O, Perdereau F, Agman G, Jeammet P (2009) Detemining factors for target weights in an anorexia nervosa inpatient program for adolescents and young adults: study on the links between theory-based hypotheses and the realities of clinical practice. Eat Weight Disord 14(4):e176–e183

    Article  CAS  Google Scholar 

  20. Strik Lievers L, Curt F, Wallier J, Perdereau F, Rein Z, Jeammet P, Godart N (2009) Predictive factors of length of inpatient treatment in anorexia nervosa. Eur Child Adolesc Psychiatry 18(2):75–84. doi:10.1007/s00787-008-0706-8

    Article  PubMed  Google Scholar 

  21. HAS (2010) Anorexie mentale: prise en charge. Recommandations pour la pratique clinique. https://www.has-sante.fr

  22. Rothman KJ (1990) No adjustments are needed for multiple comparisons. Epidemiology 1(1):43–46

    Article  CAS  Google Scholar 

  23. Errichiello L, Iodice D, Bruzzese D, Gherghi M, Senatore I (2016) Prognostic factors and outcome in anorexia nervosa: a follow-up study. Eat Weight Disord 21(1):73–82. doi:10.1007/s40519-015-0211-2

    Article  PubMed  Google Scholar 

  24. Vignaud M, Constantin JM, Ruivard M, Villemeyre-Plane M, Futier E, Bazin JE, Annane D (2010) Refeeding syndrome influences outcome of anorexia nervosa patients in intensive care unit: an observational study. Crit Care 14(5):R172. doi:10.1186/cc9274

    Article  PubMed  PubMed Central  Google Scholar 

  25. Ramsay R, Ward A, Treasure J, Russell GF (1999) Compulsory treatment in anorexia nervosa. Short-term benefits and long-term mortality. Br J Psychiatry 175:147–153

    Article  CAS  Google Scholar 

  26. Hebebrand J, Himmelmann GW, Herzog W, Herpertz-Dahlmann BM, Steinhausen HC, Amstein M, Seidel R, Deter HC, Remschmidt H, Schafer H (1997) Prediction of low body weight at long-term follow-up in acute anorexia nervosa by low body weight at referral. Am J Psychiatry 154(4):566–569

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Chantal Stheneur.

Ethics declarations

Source of funding

Fondation de France; Fondation PFIZER.

Conflict of interest

All authors declare that they have no conflict of interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Direction Générale de la Santé (French health authority) July 22nd 2007, the Comité Consultatif des Personnes se prêtant à la Recherche Biomédicale (biomedical research committee), April 24th 2007, the French Committee for personal freedoms (CNIL), October 30th 2007, and an independent review board (CCTIRS, Comité Consultatif sur le Traitement de l’Information en matière de Recherche dans le domaine de la Santé.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Stheneur, C., Ali, A., Tric, L. et al. Impact of somatic severity on long-term mortality in anorexia nervosa. Eat Weight Disord 22, 285–289 (2017). https://doi.org/10.1007/s40519-016-0346-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40519-016-0346-9

Keywords

Navigation