Thirty-year outcome of anorexia nervosa: healthcare use and disability
Bibliographic record
Abstract
Background Anorexia nervosa is associated with high personal and financial costs for sufferers, carers and society in general, but little is known about the long-term health economic burden. Aims To examine healthcare utilisation, social assistance, sick leave and disability pension in individuals with anorexia nervosa over a period of 30 years. Method Fifty-one individuals with adolescent-onset anorexia nervosa and 51 matched comparison cases (COMP) were recruited in the community and followed prospectively from 1985. All individuals were examined on five occasions. At the 30-year follow-up, mean age 44, data on in- and out-patient care, prescribed medications, social assistance, sick leave and disability pension were collected from Swedish national registers. Results The anorexia nervosa group had more days of in-patient care ( p < 0.001) and out-patient visits to psychiatry ( p < 0.001), more days of sick leave ( p = 0.006), more days of disability pension ( p = 0.002) and were prescribed more psychotropic medication ( p = 0.045) compared with the COMP group. Of the anorexia nervosa group, 22% had ever received a disability pension compared with 2% in the COMP group ( p = 0.004) and less than half the anorexia nervosa group worked full-time at the 30-year follow-up. In the anorexia nervosa group, 45% had received social assistance at some point, compared with 22% in the COMP group ( p = 0.02). Age at onset of anorexia nervosa emerged as a predictor of healthcare utilisation with significant odds ratios for psychiatric in-patient (odds ratio 0.61, 95% CI: 0.39, 0.94; p = 0.027) and out-patient care (odds ratio 0.63, 95% CI: 0.40, 0.98; p = 0.042), i.e. individuals with a later onset of anorexia nervosa were less likely to require psychiatric care. Conclusions The long-term burden of adolescent-onset anorexia nervosa comprises increased utilisation of healthcare and dependence on society for a significant minority. A later onset of anorexia nervosa predicted a lower healthcare utilisation.
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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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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".