Morbidity and mortality after adolescent eating disorders requiring inpatient care

Abstract

Purpose

This retrospective study utilized comprehensive Finnish national register data to examine the course and mortality of eating disorders among Finnish adolescent inpatients.

Methods

The study population (N = 17,112) comprised of all subjects admitted for the first time to psychiatric hospital care at age 13–17 in 1980–2010. In 10-year follow-up, morbidity and mortality were compared between those admitted for eating disorders (ED group) and other psychiatric patients (non-ED group).

Results

Of the study population, 1081 were ED patients (1031 female and 50 male). Mean age was 15 (SD = 1) in both ED and non-ED groups, and the mean follow-up time was 7.7 (SD = 2.2) and 8.4 years (SD = 2.1), respectively. Over 50% of the patients had readmissions during follow-up, the ED group having a higher risk for readmissions. Crude mortality rate (CMR) was 1.5 in the ED group and 2.9 in the non-ED group. Suicide was the most common cause of death: 43.8% in the ED group vs. 52.9% in the non-ED group (p = .28). In multivariate analyses, ED at index admission predicted rehospitalizations but, compared to other disorders, was not associated with increased mortality.

Conclusion

In the ED group, psychiatric readmissions were more common, but in contrast to earlier reports, mortality was not higher than in other psychiatric disorders. The subjects were treated in specialized adolescent psychiatric services. The prognosis of adolescent onset EDs may improve when treatment is developmentally sensitive.

Keywords:

• eating disorders
• adolescence
• morbidity
• mortality
• readmission

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The datasets are available from the second author (T.H.) on reasonable request.

Additional information

Funding

This work was supported by Tampere University Hospital Research Fund (MK201).

Notes on contributors

S. Tuohisto-Kokko

Sara Tuohisto-Kokko, BM, a fifth-year medical student at Tampere University, Finland.

T. Holttinen

Timo Holttinen, MD, PhD, Clinical Instructor at Tampere University, Finland and Specialist in Adolescent Psychiatry at Tampere University Hospital, Department of Adolescent Psychiatry, Finland.

R. Kaltiala

Riittakerttu Kaltiala, MD, PhD, Professor of Adolescent Psychiatry at Tampere University, Finland, Chief Psychiatrist at Tampere University Hospital, Department of Adolescent Psychiatry, Finland, and Senior Research Fellow at Vanha Vaasa Hospital, Finland.