Systematic Review and Meta-Analysis of Mortality in Patients With Anorexia Nervosa

Area of Science:

• Psychiatry
• Public Health
• Epidemiology

Background:

• Anorexia nervosa (AN) is a severe psychiatric disorder with a high mortality rate.
• Understanding the excess mortality associated with AN is crucial for clinical management and public health strategies.

Purpose of the Study:

• To systematically review and meta-analyze the all-cause mortality in patients with Anorexia Nervosa (AN) compared to the general population.
• To determine the standardized mortality ratio (SMR) for AN patients and identify key causes of death.

Main Methods:

• A comprehensive literature search was conducted across multiple databases (MEDLINE, PsycINFO, EMBASE, WOS, etc.) for longitudinal studies.
• Risk of bias was assessed using the Newcastle-Ottawa Scale.
• Random-effects meta-analysis was performed, including subgroup and meta-regression analyses to compare SMRs for male and female samples.

Main Results:

• Thirty studies involving 33,176 patients were included, with a pooled SMR of 5.06 (95% CI [3.47-7.38]) for AN patients.
• Suicide and cardiac deaths were significant contributors, accounting for 21% and 19% of deaths, respectively.
• Lower mean BMI was associated with higher SMRs, and SMRs for male and female samples were comparable.

Conclusions:

• Anorexia nervosa (AN) remains a critical psychiatric disorder with significantly elevated mortality.
• Emphasis on suicide prevention and cardiac monitoring is essential for AN patient care.
• Low BMI is a vital clinical indicator for identifying high-risk individuals and guiding resource allocation.