Factors predictive of ten-year mortality in severe anorexia nervosa patients.

OBJECTIVE: Little is known concerning mortality and predictive factors for anorexia nervosa in-patients. This study aimed to establish mortality rates and identify predictors in a large sample of adults through a 10-year post in-patient treatment follow-up. METHOD: Vital status was established for 601 anorexia nervosa (DSM-IV) consecutive in-patients with initial evaluation at admission. Standardized mortality ratio (SMR) was calculated. Cox analyses for hypothesized predictors of mortality were performed. RESULTS: Forty deaths were recorded. SMR was 10.6 [CI 95% (7.6-14.4)]. Six factors at admission were associated with death: older age, longer eating disorder duration, history of suicide attempt, diuretic use, intensity of eating disorder symptoms, and desired body mass index at admission. CONCLUSION: Anorexia nervosa in-patients are at high risk of death. This risk can be predicted by both chronicity and seriousness of illness at hospitalization. These elements should be considered as warnings to adapt care provision and could be targeted by treatment.

Selective processing of eating and body words in restricting-type anorexics, binge-eating-type anorexics, bulimics, and control subjects.

A French adaptation of the Stroop colour-naming task was used to investigate selective processing of information related to eating and the body in 92 female subjects: 18 with restricting-type anorexia nervosa (RAs), 25 with binge-eating-type anorexia (BAs), 20 with bulimia nervosa (BNs), and 29 controls (Cs). All participants were significantly slower in colour-naming words related to eating and the body. This suggests that eating and body Stroop effects were not diagnostic category effects. Eating Stroop effect was significantly stronger in eating disordered patients than in Cs, but very similar in RAs, BAs, and BNs. It did not correlate with the body mass index nor with Eating Disorder Inventory (EDI) scores. Body Stroop effect did not differ significantly between groups. However some of our results suggested a tendency for this effect to be higher in BNs, corroborating previous literature data. Body Stroop effect correlated with EDI score in RAs, and with the "body dissatisfaction" subscale score in BNs and BAs. It did not correlate with the body mass index. Further studies are currently being carried out to determine whether inpatient treatment for anorexia nervosa induces significant changes in eating and/or body Stroop effect, and whether such changes might be predictive of clinical outcome.