Purging disorder: a pathway to death? A review of 11 cases

With data from the Christina-Barz-Study, we report mortality rates and predictors of death in purging disorder (PurD) as well as additional information concerning the fatal cases.

The study was conducted with 225 consecutively admitted inpatients during the years 1999-2005. About 9 years later, fatal cases were identified by local registration office records. The standardised mortality ratio (SMR) was calculated through mortality tables of the Federal Office of Statistics, Germany. To identify predictors of death, survival analyses were performed. Spouses, relatives or doctors of the deceased were consulted by interview or questionnaire for further information of pathogenesis and circumstances of death.

Six of the 225 sample individuals could not be located for the follow-up. Eleven of 219 former inpatients had died during the follow-up interval. The crude mortality rate was 5.0%. The SMR was 3.90 [95% confidence interval (2.05; 7.21)]. Age at admission and presence of one or more co-morbid somatic illnesses at admission were factors associated with a shorter time period until death.

Our data indicate that there is a higher number of deaths within the study population than expected. Paying particular attention to age and the severity of co-morbid somatic symptoms could improve the outcome of patients with PurD.