Suicide attempts in anorexia nervosa.
OBJECTIVE
To explore prevalence and patterns of suicidal attempts in persons with anorexia nervosa (AN).


METHODS
Participants were the first 432 persons (22 male, 410 female) enrolled in the NIH funded Genetics of Anorexia Nervosa Collaborative Study. All participants had current or lifetime AN. The participants ranged in age from 16 to 76 (mean = 30.4, SD = 11.3). Suicidal behavior and intent was assessed via the Diagnostic Interview for Genetic Studies. We compared frequency and severity of attempts across diagnostic subtypes and comorbidity, and personality features associated with the presence of suicide attempts in persons with AN.


RESULTS
About 16.9% of those with AN attempted suicide. Significantly fewer persons with the restricting subtype (7.4%) reported at least one attempt than those with purging AN (26.1%), AN with binge eating (29.3%), and a mixed picture of AN and bulimia nervosa (21.2%). After controlling for major depression, suicide attempts were associated with substance abuse, impulsive behaviors and traits, Cluster B personality disorders, panic disorder, and post-traumatic stress disorder as well as low self-directedness and eating disorder severity.


CONCLUSIONS
Suicide attempts in AN are not uncommon, are frequently associated with the intention to die, occur less frequently in persons with the restricting subtype of the illness, and after controlling for depression are associated with a constellation of behaviors and traits associated with behavioral and affective dyscontrol.
Bulik
Cynthia M
CM
Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Drive, CB #7160, Chapel Hill, NC 27599-7160, USA. cbulik@med.unc.edu
Thornton
Laura
L
Pinheiro
Andréa Poyastro
AP
Plotnicov
Katherine
K
Klump
Kelly L
KL
Brandt
Harry
H
Crawford
Steve
S
Fichter
Manfred M
MM
Halmi
Katherine A
KA
Johnson
Craig
C
Kaplan
Allan S
AS
Mitchell
James
J
Nutzinger
Detlev
D
Strober
Michael
M
Treasure
Janet
J
Woodside
D Blake
DB
Berrettini
Wade H
WH
Kaye
Walter H
WH
D000293:Adolescent; D000328:Adult; D000342:Affective Symptoms / Q000453:epidemiology / Q000523:psychology; D000368:Aged; D000856:Anorexia Nervosa / Q000453:epidemiology* / Q000235:genetics / Q000523:psychology; D052018:Bulimia Nervosa / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics / Q000523:psychology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000453:epidemiology / Q000235:genetics / Q000523:psychology; D005260:Female; D020022:Genetic Predisposition to Disease / Q000235:genetics / Q000523:psychology; D006801:Humans; D015994:Incidence; D033182:Intention; D008297:Male; D008875:Middle Aged; D010554:Personality Disorders / Q000453:epidemiology / Q000235:genetics / Q000523:psychology; D010555:Personality Inventory; D010641:Phenotype; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000235:genetics / Q000523:psychology; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000235:genetics / Q000523:psychology; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data*