{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T09:37:00Z","timestamp":1785404220317,"version":"3.56.0"},"reference-count":46,"publisher":"Royal College of Psychiatrists","license":[{"start":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T00:00:00Z","timestamp":1765497600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Br J Psychiatry"],"abstract":"<jats:sec id=\"S0007125025104947_as1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125025104947_as2\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To examine healthcare utilisation, social assistance, sick leave and disability pension in individuals with anorexia nervosa over a period of 30 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125025104947_as3\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125025104947_as4\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The anorexia nervosa group had more days of in-patient care (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001) and out-patient visits to psychiatry (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), more days of sick leave (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.006), more days of disability pension (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.002) and were prescribed more psychotropic medication (\n                      <jats:italic>p<\/jats:italic>\n                      = 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 (\n                      <jats:italic>p<\/jats:italic>\n                      = 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 (\n                      <jats:italic>p<\/jats:italic>\n                      = 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;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.027) and out-patient care (odds ratio 0.63, 95% CI: 0.40, 0.98;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.042), i.e. individuals with a later onset of anorexia nervosa were less likely to require psychiatric care.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125025104947_as5\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1192\/bjp.2025.10494","type":"journal-article","created":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T05:12:11Z","timestamp":1765516331000},"page":"1-9","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Thirty-year outcome of anorexia nervosa: healthcare use and disability"],"prefix":"10.1192","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-5912-0717","authenticated-orcid":false,"given":"Sandra Rydberg","family":"Dobrescu","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01tm6cn81","id-type":"ROR","asserted-by":"publisher"}],"name":"Institute of Neuroscience and Physiology, University of Gothenburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Dinkler","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01tm6cn81","id-type":"ROR","asserted-by":"publisher"}],"name":"Institute of Neuroscience and Physiology, University of Gothenburg"},{"name":"Karolinska Institutet"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I. Carina","family":"Gillberg","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01tm6cn81","id-type":"ROR","asserted-by":"publisher"}],"name":"Institute of Neuroscience and Physiology, University of Gothenburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Gillberg","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01tm6cn81","id-type":"ROR","asserted-by":"publisher"}],"name":"Institute of Neuroscience and Physiology, University of Gothenburg"},{"name":"University of Glasgow"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"R\u00e5stam","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01tm6cn81","id-type":"ROR","asserted-by":"publisher"}],"name":"Institute of Neuroscience and Physiology, University of Gothenburg"},{"name":"Child and Adolescent Psychiatry, Lund University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristian","family":"Bolin","sequence":"additional","affiliation":[{"name":"University of Gothenburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabet","family":"Wentz","sequence":"additional","affiliation":[{"name":"Institute of Neuroscience and Physiology, University of Gothenburg"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2025,12,12]]},"reference":[{"key":"S0007125025104947_ref19","doi-asserted-by":"publisher","DOI":"10.1002\/erv.3015"},{"key":"S0007125025104947_ref7","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291705004708"},{"key":"S0007125025104947_ref14","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.105.018820"},{"key":"S0007125025104947_ref16","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.158.4.495"},{"key":"S0007125025104947_ref32","volume-title":"Eighth Revision of the International Classification of Diseases","year":"1966"},{"key":"S0007125025104947_ref25","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.2019.113"},{"key":"S0007125025104947_ref24","volume-title":"Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR","year":"2000"},{"key":"S0007125025104947_ref18","doi-asserted-by":"publisher","DOI":"10.1002\/eat.22415"},{"key":"S0007125025104947_ref13","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291707001833"},{"key":"S0007125025104947_ref1","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2011.74"},{"key":"S0007125025104947_ref27","doi-asserted-by":"publisher","DOI":"10.1111\/1469-7610.00757"},{"key":"S0007125025104947_ref3","doi-asserted-by":"publisher","DOI":"10.1007\/s10741-019-09911-0"},{"key":"S0007125025104947_ref22","first-page":"642","article-title":"Anorexia nervosa in a Swedish urban region. 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