Mortality Rate of Anorexia Nervosa

1
Mortality Rate of Anorexia Nervosa

• Is the mortality rate associated with AN greater
  than average?
• Is the mortality rate of AN higher than that of
  other mental illnesses?
• By,
• Jessie Gross

2
Overview

• Basic facts about AN
• Side effects of AN
• Factors that contribute to a high mortality rate
  in AN
• Facts about the treatment methods of AN
• Argumentative data
• Mortality facts about people with AN

3
Basic Facts

• An estimated 8 million Americans currently suffer
  from an eating disorder (7 million women 1
  million men)
• 1 in 200 women suffer from anorexia
• Eating disorders are believed to have the highest
  mortality rate of any mental illness

• DMH

4
The Harsh Reality

• 0.5 of girls 15-19 have AN about .25 in women
  20-24
• 400 new cases are diagnosed each year
• 5,000 patients have AN at any one time
• Risk of first degree relative developing the
  disease is 10x greater
• Death from natural causes is 4x greater
• Deaths from unnatural causes 11x greater
• The risk of successful suicide is 32x greater
  than average

5
Side Effects of AN

• -psychiatric morbidity is common dysthymia,
  major depression and obsessive-compulsive
  disorder
• Leads to brain atrophy and disorder of
  myelination, can have a persistent effect on
  cognition
• Cardiac arrhythmias are common case of sudden
  death in AN
• Long term physical morbidity is common and
  serious
• Growth retardation is present in patients who
  have an early onset
• Infertility is common in women who only partially
  recovered
• Osteopenia leading to osteoporosis is a serious
  complication
• More women die as a result of a fractured femur
  than breast cancer
• Renal and hepatic functions are frequently
  permanently impaired
• Neurogenic bowel with rectal prolapse is common,
  sometimes but not always associated with laxative
  abuse

6
National Association of Anorexia Nervosa and
Associated Disorders

• 5-10 of anorexics die within 10 years of
  contracting the disease
• 18-20 will be dead after 20 years
• Only 30-40 will fully recover
• The mortality rate associated with AN is 12x
  higher than ALL other causes of death for females
  15-24 years old
• 20 people with AN prematurely die from related
  complications including suicide and heart problems

7
Dept. of Psychiatry, University of British
Columbia, Vancouver, British Columbia, Canada

• Cross-sectional study done at St. Pauls Hospital
  (1981-2000)
• Out of 954 patients, 326 diagnosed with AN
• All diagnosed patients completed a 20 year
  assessment
• SMR 10.5 (95 confidence interval)
• Study confirms high mortality rate within the AN
  population
• Wiley

8
University of Psychological Medicine,
Christchurch School of Medicine, New Zealand

• Meta-analytic study using weighted linear
  regression used to combine mortality proportions
  from 42 published studies
• Studies used to estimate mortality rate of AN
  over time
• 178 deaths out of 3,006 anorexics 5.9
• The mortality rate 0.56 per year and 5.6 per
  decade
• Conclusion estimated mortality rate for AN is
  much greater than that reported for female
  psychiatric patients and the general population
• pubMed

9
Contributing Factors to a High Mortality Rate

• Only 1 in 10 people with an eating disorder
  receive treatment
• 80 of females who have sought help do not
  receive the intensity of treatment they need-most
  are sent home to soon
• Treatment in the U.S. ranges from 500-2,000 per
  day! Average cost of inpatient treatment is
  30,000 per month!
• The estimated length off treatment needed is 3-6
  months
• Health insurance companies do not typically cover
  the cost of treatment
• Outpatient treatment including therapy and
  medical monitoring averages at 100,000 or more
• DMH

10
Causes of High Mortality in AN

• The most common causes of death in AN are
  complications of the disorder, such as cardiac
  arrest or electrolyte imbalance, and suicide

11
Ways to Decrease AN Mortality

• 1997- 76 of sample studied for 10-15 years after
  admission met criteria for full recoverygt their
  recovery time ranged from 57-74 monthsgt 10 met
  partial recovery criteria
• 1989- Patients who reached 98 of IBW prior to
  discharge were less likely to relapse than those
  who achieved 83
• 2000- Readmissions of patients increased steadily
  as length of stays became shorter and required
  weight at discharge became smaller
• Maine

12
Supporting Evidence

• Compared 14 patients with AN who achieved normal
  weight (96 IBW) to 8 patients who reached only
  76 IBW.

Conclusion- if patients with AN were provided
with the right treatment and allowed enough time
to reach a higher BWI, their success rate will be
higher and it will be more cost effective in the
long-run
13
The Antagonist Point of View,Mayo Clinic, Canada

• Study of mortality rates of AN over a 60 year
  period
• Findingspeople with AN die at the same rate as
  people without AN
• Study recognizes it contradicts all previous
  clinical studies
• Reasoning Previous studies are generally
  conducted in hospital settings where individuals
  with the most advanced cases would me
  overrepresented
• Carnell

14
Summary

• 1 in every 200 women currently suffer from AN
• Treatment of AN is often too expensive, too
  short, and ultimately unsuccessful
• There are many long lasting side effects of AN,
  some of which are irreversible, ie brain
  atrophy, bone myelination, cardiac arrhythmias,
  growth retardation, infertility, and osteopenia.
• Deaths in AN patients due to natural causes,
  unnatural causes, and suicides are 4-32 times
  greater that average.

15
Questions Answers

• Is the mortality rate associated with AN greater
  than average?
• Yes, it is clear that the mortality rate of
  people with An is significantly greater than
  average.
• Is the mortality rate of AN higher than that of
  other mental illnesses?
• The facts show that the mortality percentages of
  AN are higher than the percentages of other
  mental illnesses.

16
Work Cited

• Carnell, Brian. Death Rate Among Anorexia
  Nervosa Patients Exaggerated. 2002.
  lthttp//www.skepticism.net/articles/2003/000017.ht
  mlgt.
• Department of Psychiatry, University of British
  Columbia. The Mortality Rate From AN. 2005.
  lthttp//www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd
  RetrievedbPubMedlist_uids16134111doptCitati
  ongt.
• Maine, Margo. Securing Eating Disorders
  Treatment Ammunition for Arguments with Third
  Parties. National Eatin Disorders Association.
  2004. lthttp//www.nationaleatingdisorders.org/neda
  Dir/files/documents/handouts/SecrTxAm.pdfgt.
• Thornton, Chris. The Harsh Reality of Eating
  Disorders. Wesley Private Hospital.
  lthttp//www.bodycage.com/harsh.htmlgt.