Journal
BRITISH JOURNAL OF PSYCHIATRY
Volume 216, Issue 2, Pages 105-112Publisher
CAMBRIDGE UNIV PRESS
DOI: 10.1192/bjp.2019.153
Keywords
Eating disorder; anorexia nervosa; bulimia nervosa; epidemiology; incidence
Categories
Funding
- Farr Institute at the Centre for Improvement in Population Health through E-records Research (CIPHER)
- Arthritis Research UK
- British Heart Foundation
- Cancer Research UK
- Economic and Social Research Council
- Engineering and Physical Sciences Research Council
- Medical Research Council (MRC)
- National Institute of Health Research
- National Institute for Social Care and Health Research (Welsh Assembly Government)
- Chief Scientist Office (Scottish Government Health Directorates)
- Wellcome Trust (MRC) [MR/K006525/1]
- Welsh Government through Health and Care Research Wales (Health Research Authority) [HRA-15-1079]
- HDR UK
- MRC
- National Institute for Health Research
- Health and Care Research Wales
- Health and Social Care Research and Development Division (Public Health Agency, Northern Ireland)
- Chief Scientist Office of the Scottish Government Health and Social Care Directorates
- Wellcome Trust [NIWA1]
- MRC [MR/K006525/1] Funding Source: UKRI
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Background Diagnosing eating disorders can be difficult and few people with the disorder receive specialist services despite the associated high morbidity and mortality. Aims To examine the burden of eating disorders in the population in terms of incidence, comorbidities and survival. Method We used linked electronic health records from general practitioner and hospital admissions in Wales, UK within the Secure Anonymised Information Linkage (SAIL) databank to investigate the incidence of new eating disorder diagnoses. We examined the frequency of comorbid diagnoses and prescribed medications in cases and controls in the 2 years before and 3 years after diagnosis, and performed a survival analysis. Results A total of 15 558 people were diagnosed with eating disorders between 1990 and 2017. The incidence peaked at 24 per 100 000 people in 2003/04. People with eating disorders showed higher levels of other mental disorders (odds ratio 4.32, 95% CI 4.01-4.66) and external causes of morbidity and mortality (odds ratio 2.92, 95% CI 2.44-3.50). They had greater prescription of central nervous system drugs (odds ratio 3.15, 95% CI 2.97-3.33), gastrointestinal drugs (odds ratio 2.61, 95% CI 2.45-2.79) and dietetic drugs (odds ratio 2.42, 95% CI 2.24-2.62) before diagnosis. These excess diagnoses and prescriptions remained 3 years after diagnosis. Mortality was raised compared with controls for some eating disorders, particularly in females with anorexia nervosa. Conclusions Incidence of diagnosed eating disorders is relatively low in the population but there is a major longer term burden in morbidity and mortality to the individual.
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