Anorexia Nervosa has the highest mortality rate among all DSM psychiatric disorders. The most common cause of death in anorexia nervosa is:
- A Cardiac arrhythmias due to electrolyte abnormalities (hypokalaemia, hypomagnesaemia) causing QT prolongation and torsades de pointes ✓
- B Suicide and self-harm
- C Renal failure from chronic dehydration
- D Pulmonary aspiration from vomiting
Correct answer: A. Cardiac arrhythmias due to electrolyte abnormalities (hypokalaemia, hypomagnesaemia) causing QT prolongation and torsades de pointes
Explanation
While suicide accounts for a significant proportion of deaths in anorexia nervosa (approximately 1 in 5 deaths), the single most common cause of death overall is cardiac complications — primarily arrhythmias due to electrolyte disturbances (hypokalaemia, hypomagnesaemia from purging/malnutrition) causing QTc prolongation, torsades de pointes, and ventricular fibrillation. Refeeding syndrome (hypophosphataemia causing cardiac failure) is another life-threatening complication in severely malnourished patients starting nutritional rehabilitation.
Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.
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