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I congratulate the authors on a very fine and much needed study on mortality in eating disorders.¹ I have but one comment. In the "Comment" section, the authors state, "To our knowledge, only one other study has reported an SMR [standardized mortality ratio] for bulimia nervosa." When submitted for publication (November 13, 2001), information from 2 overviews on this topic^2-3 should have been available to the authors. One article was published in March/April 1998,² and the other in June 2001.³ I have updated the findings on SMR in bulimia nervosa in Table 1. A simulation exercise based on the observation of a linear relationship between expected mortality and person-years surveyed in the 6 studies in the Table 1, encompassing 43 follow-up studies of bulimia nervosa cohorts, gave an overall aggregate (pseudo) SMR of 1.6 (95% confidence interval, 0.8-2.7; P = .15). Of note is that the 6 studies reporting . . . [Full Text of this Article]

Søren Nielsen, MD
Child and Adolescent Psychiatrist
Storstrøm County Psychiatric Services
Psychiatric Youth Center
Ringstedgade 61
DK-4700 Næstved
Denmark

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