PMID- 30756148
OWN - NLM
STAT- MEDLINE
DCOM- 20191105
LR  - 20210310
IS  - 1433-9285 (Electronic)
IS  - 0933-7954 (Linking)
VI  - 54
IP  - 7
DP  - 2019 Jul
TI  - Psychiatric comorbidity as a risk factor for the mortality of people with bulimia 
      nervosa.
PG  - 813-821
LID - 10.1007/s00127-019-01667-0 [doi]
AB  - BACKGROUND: Bulimia nervosa (BN) is associated with increased mortality. Frequent 
      comorbidities of BN include substance use disorders, affective disorders and 
      personality disorders (PD). These comorbidities may add an additional risk for 
      mortality. METHODS: We investigated the influence of these psychiatric 
      comorbidities on all-cause mortality with demographic and socioeconomic factors 
      considered as confounders over an observation period from January 2007 to March 
      2016 for 1501 people with BN using anonymised health records data from the South 
      London and Maudsley NHS Foundation Trust (SLaM), retrieved through its Clinical 
      Records Interactive Search (CRIS) data resource. Mortality was ascertained 
      through monthly linkages to the nationwide tracing system administered by the 
      Office for National Statistics (ONS). We used Cox proportional hazards regression 
      to calculate hazard ratios (HRs) with 95% confidence intervals (CIs). 
      Multivariable analyses were also performed to estimate effects when controlling 
      for confounding of age, sex, ethnicity, borough, marital status and deprivation 
      score. RESULTS: A total of 18 patients with BN died during the observation 
      period. The standardised mortality ratio (SMR) for our study cohort (against the 
      population of England and Wales in 2012 as a standard) was 2.52 (95% CI 
      1.49-3.97). Cox regressions revealed significant associations of mortality with 
      older age and male gender. Comorbid PD (HR: 3.36; 95% CI 1.05-10.73) was 
      significantly associated with all-cause mortality, even after controlling for 
      demographic and socioeconomic covariates. CONCLUSIONS: These results highlight 
      increased mortality in patients with BN and the importance of recognising and 
      treating PDs in patients with BN.
FAU - Himmerich, Hubertus
AU  - Himmerich H
AD  - Department of Psychological Medicine, King's College London, London, UK.
AD  - South London and Maudsley NHS Foundation Trust, London, UK.
FAU - Hotopf, Matthew
AU  - Hotopf M
AD  - Department of Psychological Medicine, King's College London, London, UK.
AD  - South London and Maudsley NHS Foundation Trust, London, UK.
FAU - Shetty, Hitesh
AU  - Shetty H
AD  - South London and Maudsley NHS Foundation Trust, London, UK.
FAU - Schmidt, Ulrike
AU  - Schmidt U
AD  - Department of Psychological Medicine, King's College London, London, UK.
AD  - South London and Maudsley NHS Foundation Trust, London, UK.
FAU - Treasure, Janet
AU  - Treasure J
AD  - Department of Psychological Medicine, King's College London, London, UK.
AD  - South London and Maudsley NHS Foundation Trust, London, UK.
FAU - Hayes, Richard D
AU  - Hayes RD
AD  - Department of Psychological Medicine, King's College London, London, UK.
FAU - Stewart, Robert
AU  - Stewart R
AD  - Department of Psychological Medicine, King's College London, London, UK.
AD  - South London and Maudsley NHS Foundation Trust, London, UK.
FAU - Chang, Chin-Kuo
AU  - Chang CK
AD  - Department of Psychological Medicine, King's College London, London, UK. 
      ckchang@utaipei.edu.tw.
AD  - South London and Maudsley NHS Foundation Trust, London, UK. 
      ckchang@utaipei.edu.tw.
AD  - Department of Health and Welfare, University of Taipei, No. 101, Sec. 2, 
      Jhongcheng Rd, Shilin District, Taipei, 111, Taiwan. ckchang@utaipei.edu.tw.
LA  - eng
GR  - MC_PC_17214/MRC_/Medical Research Council/United Kingdom
GR  - BRC-2011-10035/National Institute for Health Research/
PT  - Journal Article
DEP - 20190211
PL  - Germany
TA  - Soc Psychiatry Psychiatr Epidemiol
JT  - Social psychiatry and psychiatric epidemiology
JID - 8804358
SB  - IM
MH  - Adult
MH  - Aged
MH  - Bulimia Nervosa/*mortality/psychology
MH  - Cause of Death
MH  - Cohort Studies
MH  - Comorbidity
MH  - England/epidemiology
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mood Disorders/*mortality/psychology
MH  - Personality Disorders/*mortality/psychology
MH  - Proportional Hazards Models
MH  - Risk Factors
MH  - Socioeconomic Factors
MH  - Substance-Related Disorders/*mortality/psychology
MH  - Wales/epidemiology
OTO - NOTNLM
OT  - Affective disorders
OT  - Bulimia nervosa
OT  - Eating disorder
OT  - Personality disorder
OT  - Psychiatric comorbidities
OT  - Substance use disorders
EDAT- 2019/02/14 06:00
MHDA- 2019/11/07 06:00
CRDT- 2019/02/14 06:00
PHST- 2018/05/28 00:00 [received]
PHST- 2019/02/04 00:00 [accepted]
PHST- 2019/02/14 06:00 [pubmed]
PHST- 2019/11/07 06:00 [medline]
PHST- 2019/02/14 06:00 [entrez]
AID - 10.1007/s00127-019-01667-0 [pii]
AID - 10.1007/s00127-019-01667-0 [doi]
PST - ppublish
SO  - Soc Psychiatry Psychiatr Epidemiol. 2019 Jul;54(7):813-821. doi: 
      10.1007/s00127-019-01667-0. Epub 2019 Feb 11.