Systematic Review and Meta‐Analysis of Mortality in Patients With Anorexia Nervosa
Bibliographic record
Abstract
OBJECTIVE: Anorexia nervosa (AN) has one of the highest mortality rates among psychiatric disorders. This systematic review and meta-analysis examined the all-cause mortality of AN patients compared to the general population using the standardized mortality ratio (SMR). METHOD: MEDLINE, PsycINFO, EMBASE, WOS, Dissertations and Theses A&I, and Google Scholar were searched from inception to May 2025 for longitudinal studies reporting all-cause SMR for AN patients. Risk of bias was assessed using the Newcastle-Ottawa Scale. Random-effects meta-analysis was conducted and presented as a forest plot. Subgroup and meta-regression analyses were done. SMRs for male- and female-specific samples were compared. RESULTS: Thirty studies involving 33,176 patients were identified. The pooled SMR from 22 studies was 5.06 (95% CI [3.47-7.38]). Suicide and cardiac deaths accounted for 21% and 19% of deaths, respectively. Studies with lower mean BMI were associated with higher SMRs before correction for multiple testing (p = 0.018, adjusted p = 0.252). The pooled SMR of male-specific samples was 3.47, 95% CI (1.60-7.52), similar to female-specific samples (3.86, 95% CI [1.82-8.20]). DISCUSSIONS: Our findings confirm that AN remains a severe psychiatric disorder, underscoring the clinical importance of suicide prevention and monitoring cardiac complications. A low BMI is a crucial clinical indicator for high-risk groups and allocating resources. Limitations include excluding studies with zero deaths, substantial heterogeneity among included studies, the underrepresentation of male and non-Western populations, and most studies originating from specialist clinics.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.014 | 0.033 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.016 | 0.037 |
| Bibliometrics | 0.007 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".