Conflict of Interest: JSH, AA, and KH have nothing to declare. RKS has received a lecture fee from Astra Zeneca (2010). KB has received lecture fees and grant support from Merck Sharpe and Dohme since 2002.
Contexts of Treatment
Reflections on involuntary treatment in the prevention of fatal anorexia nervosa: A review of five cases†
Article first published online: 22 FEB 2011
Copyright © 2011 Wiley Periodicals, Inc.
International Journal of Eating Disorders
Volume 45, Issue 1, pages 93–100, January 2012
How to Cite
Holm, J. S., Brixen, K., Andries, A., Hørder, K. and Støving, R. K. (2012), Reflections on involuntary treatment in the prevention of fatal anorexia nervosa: A review of five cases. Int. J. Eat. Disord., 45: 93–100. doi: 10.1002/eat.20915
- Issue published online: 14 DEC 2011
- Article first published online: 22 FEB 2011
- Manuscript Accepted: 26 NOV 2010
- Beatrice Surovell Haskell Foundation for Child Mental Health Research of Copenhagen
- Institute of Clinical Research, University of Southern Denmark
- anorexia nervosa;
- eating disorder;
- fatal outcome;
- involuntary treatment
Involuntary treatment in the prevention of fatal anorexia nervosa (AN) is still controversial.
Five fatal cases of AN were identified out of 1,160 patients who attended a specialized eating disorder unit between 1994 and 2006. Information on inpatient, ambulatory, and emergency room treatment was extracted from a population-based registration system.
Personality disorders were diagnosed in all five patients and substance abuse in three patients. In all cases, illness duration was more than 10 years and late onset was seen in two cases. None of the deaths were due to suicide. Involuntary hospital admission was instituted for three patients, but only one patient was compulsory detained more than once. Four patients died after having discontinued treatment.
Compulsory treatment may be of crucial importance in the prevention of fatalities in patients with long-standing AN and psychiatric comorbidity who discontinue treatment. © 2011 by Wiley Periodicals, Inc. (Int J Eat Disord 2012)