Suicide attempts in bulimia nervosa: personality and psychopathological correlates.
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.
Forcano
Laura
L
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.
Fernández-Aranda
Fernando
F
Alvarez-Moya
Eva
E
Bulik
Cynthia
C
Granero
Roser
R
Gratacòs
Mònica
M
Jiménez-Murcia
Susana
S
Krug
Isabel
I
Mercader
Josep M
JM
Riesco
Nadine
N
Saus
Ester
E
Santamaría
Juan José
JJ
Estivill
Xavier
X
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*