Increased Mortality in Bulimia Nervosa and Other Eating Disorders
ABSTRACT Anorexia nervosa has been consistently associated with increased mortality, but whether this is true for other types of eating disorders is unclear. The goal of this study was to determine whether anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified are associated with increased all-cause mortality or suicide mortality.
Using computerized record linkage to the National Death Index, the authors conducted a longitudinal assessment of mortality over 8 to 25 years in 1,885 individuals with anorexia nervosa (N=177), bulimia nervosa (N=906), or eating disorder not otherwise specified (N=802) who presented for treatment at a specialized eating disorders clinic in an academic medical center.
Crude mortality rates were 4.0% for anorexia nervosa, 3.9% for bulimia nervosa, and 5.2% for eating disorder not otherwise specified. All-cause standardized mortality ratios were significantly elevated for bulimia nervosa and eating disorder not otherwise specified; suicide standardized mortality ratios were elevated for bulimia nervosa and eating disorder not otherwise specified.
Individuals with eating disorder not otherwise specified, which is sometimes viewed as a "less severe" eating disorder, had elevated mortality risks, similar to those found in anorexia nervosa. This study also demonstrated an increased risk of suicide across eating disorder diagnoses.
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ABSTRACT: Objective. In Romania medical-legal studies on the pattern of drug consumption have not yet been conducted nationwide; the purpose of this study was, therefore, to determine whether such a pattern could be identified. Methods. A total number of 577 analyses were performed during a three-year period on people suspected of non-lethal substance abuse, in more than two-thirds of the counties in Romania. Preliminary tests were conducted using immunoassay tests (blood or urine) and confirmatory tests were carried out using either GC-MS or HPLC. Results. 240 cases (41.6%) were negative while 327 cases (58.4%) tested positive for illegal drugs, central nervous system medication or both. Men represented 89.5% of all cases, while women accounted for only 10.5%. The pattern of substance abuse varied significantly, depending on the geographical area. In most cases, the identified drugs of abuse were cannabinoids and opiates, with a significantly different distribution of cases, depending on the geographical area. The highest number of positive cases was identified in the month of October, whereas the smallest numbers were identified in July and December. The annual trend of consumption revealed a significant decrease in the analysed substances in 2011. Conclusions. Our study has determined the presence of a specific pattern of consumption in different geographical areas - a result that suggests the need for more targeted prevention programmes, addressing local particularities in consumption behaviours. A significant decrease in the identification of drugs of abuse in the third year of our study, combined with data attesting the significant increase in the consumption of legal highs suggests that the forensic toxicology laboratories need to be equipped with apparatus able to detect these newer substances of abuse more efficiently.Heroin Addiction and Related Clinical Problems 01/2014; 16(3):7-13. · 0.35 Impact Factor
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ABSTRACT: Intraoral disease is a common occurrence in patients with eating disorders, particularly dental erosion, which frequently becomes severe and may hinder daily life. The severity varies from patient to patient. Understanding the underlying mechanisms may help prevent dental erosion in these patients. Accordingly, we investigated the relationship between the severity of erosion and the behavior of patients with eating disorders, with a focus on daily diet and vomiting behavior. A total 71 female eating disorder outpatients from the Clinical Center of Psychosomatic Dentistry of Nippon Dental University Hospital and the Psychosomatic Internal Medicine Department of Kudanzaka Hospital or who were hospitalized at Hasegawa Hospital were enrolled. Dental erosion severity and location were determined by oral examination. Patients who induced vomiting were queried on their behavior during vomiting and on routine diet habits. Patients with dental erosion were further divided into mild and severe groups based on the lesion severity and the groups compared. Dental erosion was observed in 43 of 50 subjects who induced vomiting. Dental erosion was most frequent on the palatal side of the anterior maxillary teeth, occurring in 81.3% of the subjects. There were significant differences observed between the mild and severe groups according to post-vomiting oral hygiene. Significantly more subjects in the mild group consumed large amounts of water before vomiting, and significantly more subjects in the severe group routinely consumed carbonated beverages or sweetened food. While self-induced vomiting is the main cause of dental erosion in eating disorder patients, the erosion severity may be affected by behavior when inducing vomiting or by routine consumption of certain foods and beverages. Addressing these factors may help prevent severe dental erosion in patients who chronically induce vomiting.BioPsychoSocial Medicine 11/2014; 8:25. DOI:10.1186/1751-0759-8-25
05/2015; 3(2):221-229. DOI:10.1080/21662630.2014.968177