title: Suicide attempts in bulimia nervosa: personality and psychopathological correlates.
abstract: BACKGROUND
  Little evidence exists about suicidal acts in eating disorders and its relation with personality. We explored the prevalence of lifetime suicide attempts (SA) in women with bulimia nervosa (BN), and compared eating disorder symptoms, general psychopathology, impulsivity and personality between individuals who had and had not attempted suicide. We also determined the variables that better correlate with of SA.
  
  
  METHODS
  Five hundred sixty-six BN outpatients (417 BN purging, 47 BN non-purging and 102 subthreshold BN) participated in the study.
  
  
  RESULTS
  Lifetime prevalence of suicide attempts was 26.9%. BN subtype was not associated with lifetime SA (p=0.36). Suicide attempters exhibited higher rates on eating symptomatology, general psychopathology, impulsive behaviors, more frequent history of childhood obesity and parental alcohol abuse (p<0.004). Suicide attempters exhibited higher scores on harm avoidance and lower on self-directedness, reward dependence and cooperativeness (p<0.002). The most strongly correlated variables with SA were: lower education, minimum BMI, previous eating disorder treatment, low self-directedness, and familial history of alcohol abuse (p<0.006).
  
  
  CONCLUSIONS
  Our results support the notion that internalizing personality traits combined with impulsivity may increase the probability of suicidal behaviors in these patients. Future research may increase our understanding of the role of suicidality to work towards rational prevention of suicidal attempts.
authors.affiliation: Department of Psychiatry, University Hospital of Bellvitge, c/Feixa Llarga s/n, 08907 Barcelona, Spain; Ciber Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Forcano
authors.forename: Fernando
authors.initials: F
authors.lastname: Fernández-Aranda
authors.forename: Eva
authors.initials: E
authors.lastname: Alvarez-Moya
authors.forename: Cynthia
authors.initials: C
authors.lastname: Bulik
authors.forename: Roser
authors.initials: R
authors.lastname: Granero
authors.forename: Mònica
authors.initials: M
authors.lastname: Gratacòs
authors.forename: Susana
authors.initials: S
authors.lastname: Jiménez-Murcia
authors.forename: Isabel
authors.initials: I
authors.lastname: Krug
authors.forename: Josep M
authors.initials: JM
authors.lastname: Mercader
authors.forename: Nadine
authors.initials: N
authors.lastname: Riesco
authors.forename: Ester
authors.initials: E
authors.lastname: Saus
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Santamaría
authors.forename: Xavier
authors.initials: X
authors.lastname: Estivill
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000453:epidemiology; D015992:Body Mass Index; D052018:Bulimia Nervosa / Q000453:epidemiology*; D002648:Child; D016241:Child of Impaired Parents / Q000706:statistics & numerical data; D015897:Comorbidity; D005260:Female; D006801:Humans; D007175:Impulsive Behavior / Q000453:epidemiology; D007389:Internal-External Control; D001523:Mental Disorders / Q000453:epidemiology*; D009765:Obesity / Q000453:epidemiology; D010290:Parents; D010551:Personality; D015995:Prevalence; D012959:Socioeconomic Factors; D013030:Spain / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology; D013406:Suicide, Attempted / Q000706:statistics & numerical data*