Psychopathological distress predicts suicidal ideation and self-harm in adolescent eating disorder outpatients.
OBJECTIVE
This study evaluated the differences in suicidal behaviour between adolescent anorexia nervosa (AN) and bulimia nervosa (BN), and the association of age, menarche timing, duration of eating disorder (ED), depression and general psychopathological symptoms (GSI) with suicidal behaviour in adolescent ED.


METHODS
The study group comprised 57 adolescent outpatients (girls) attending for assessment because of eating disorders. Suicidal ideation, deliberate self-harm and suicidal attempts were assessed in self-report questionnaires.


RESULTS
In both ED groups, one adolescent had attempted suicide before assessment. Suicidal ideation and/or deliberate self-harm were reported in over half of the cases. Bulimics had significantly more suicidal ideation and deliberate self-harm than anorectics. In multivariate analysis, BN and depression predicted suicidal ideation, but only GSI persisted as predicting deliberate self-harm.


CONCLUSIONS
Suicidal behaviour is common in adolescent ED. Type of ED (BN), depression and higher GSI are strongly associated with suicidal ideation and deliberate self-harm. Our results point to the need to evaluate psychopathological symptoms in adolescent ED, especially in BN, in the initial assessment to prevent severe suicidal behaviour.
Tampere School of Public Health, University of Tampere, Tampere, Finland. Jaana.Ruuska@uta.fi
Jaana
J
Ruuska
Riittakerttu
R
Kaltiala-Heino
Päivi
P
Rantanen
Anna-Maija
AM
Koivisto
D000293:Adolescent; D000294:Adolescent Behavior; D000856:Anorexia Nervosa / Q000523:psychology*; D002032:Bulimia / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D010045:Outpatients; D011379:Prognosis; D016728:Self-Injurious Behavior; D013315:Stress, Psychological; D013406:Suicide, Attempted / Q000523:psychology*