Mortality in anorexia nervosa – a look back at and beyond one of the most cited papers in the field

Abstract

There has been a debate on the extent of the mortality in anorexia nervosa (AN), given different figures in the available studies investigating this topic. In an early meta-analysis investigating the mortality in AN entitled ‘Mortality in anorexia nervosa’, Patrick Sullivan (1995. Mortality in anorexia nervosa. American Journal of Psychiatry, 152(7), 1073–1074) pointed out that the true nature of the mortality rate over time associated with AN was masked by factors such as methodological limitations in the literature and the fact that normally only the crude mortality was reported, making the data difficult to interpret, and suggested the use of standardised mortality ratios as a means of adjusting the mortality rate for the number of expected deaths during the follow-up period. Sullivan's (1995. Mortality in Anorexia-Nervosa. American Journal of Psychiatry, 152(7), 1073–1074) paper has become the ninth most cited article in the field and 1 out of 34 citation classics, defined as an article with more than 400 citations. We look back at this seminal article to consider its relevance today and beyond it to see what we have learned since then about mortality in AN.

Keywords:

• anorexia nervosa
• mortality
• prevalence