The aim was to explore possible correlations between the oral status of patients undergoing treatment at a special outpatient psychiatric clinic for eating disorders and such variables as psychiatric diagnosis and duration of illness, oral hygiene habits, salivary function, and dietary habits. Healthy volunteers of a similar age were recruited for comparison. The material comprised 100 consecutive referrals, of whom 79 were women and 2 were men (age range 17 to 47, median 25 yr) participated. The eating disorders were diagnosed according to the American Psychiatric Association's DSM III-R criteria. The clinical and radiographic examinations were supplemented by standardized intraoral photographs, study models and salivary analysis. The decayed, missing, filled surfaces (DMFS) index was 15.3+/-10.9, a significantly higher caries frequency than for the reference group. More than half the subjects had erosive tooth wear involving the dentine, and about one-third had very low unstimulated salivary flow rates and very high counts of mutans streptococci and lactobacilli. Erosive tooth wear was significantly correlated to the number of years of binge-eating. Compared to age-matched individuals, subjects with diagnosed eating disorders are more susceptible to both dental caries and erosion. They should be encouraged to adopt appropriately tailored preventive programmes and to have regular dental check-ups.

The death rate for persons in Stockholm born in 1905 has been investigated during a 9-year period (1971-1979). In 1971 these persons were invited to participate in a health check-up. Another check-up was carried out 3 years later, during which a psychiatric examination of 589 persons was undertaken. The correlation between depressive disorders and mortality was investigated in two steps. The death rates for those subjects who had responded affirmatively to items in a questionnaire indicating depression were compared with the death rate for the remaining responders. The death rates for those subjects considered to have neurotic disorders or sleeping disturbances in the psychiatric examination were compared with the death rates for the members of a control group considered to be without psychiatric symptoms. Both methods gave fundamentally the same result: there is an excess mortality among persons with depressive symptoms compared to persons without. The death rates were significantly higher in the populations that did not participate in the health check-ups than in those who did. The rates of suicide were also greater in the non-response populations. None of the persons who participated in the 1974 health check-up committed suicide during the next 3 years. The study shows that physically and mentally healthier persons were overrepresented among those who participated in the health check-ups at the ages of 66 and 69.

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This brief account of the history of eating disorder services in Sweden is divided into two sections, one covering the history and present design of clinical eating disorder services, and the other depicting the scientific development of the eating disorders field.