title: Characteristics of suicide attempts in anorexia and bulimia nervosa: a case-control study.
abstract: OBJECTIVE
  Compared to other eating disorders, anorexia nervosa (AN) has the highest rates of completed suicide whereas suicide attempt rates are similar or lower than in bulimia nervosa (BN). Attempted suicide is a key predictor of suicide, thus this mismatch is intriguing. We sought to explore whether the clinical characteristics of suicidal acts differ between suicide attempters with AN, BN or without an eating disorders (ED).
  
  
  METHODS
  Case-control study in a cohort of suicide attempters (n = 1563). Forty-four patients with AN and 71 with BN were compared with 235 non-ED attempters matched for sex, age and education, using interview measures of suicidal intent and severity.
  
  
  RESULTS
  AN patients were more likely to have made a serious attempt (OR = 3.4, 95% CI 1.4-7.9), with a higher expectation of dying (OR = 3.7,95% CI 1.1-13.5), and an increased risk of severity (OR = 3.4,95% CI 1.2-9.6). BN patients did not differ from the control group. Clinical markers of the severity of ED were associated with the seriousness of the attempt.
  
  
  CONCLUSIONS
  There are distinct features of suicide attempts in AN. This may explain the higher suicide rates in AN. Higher completed suicide rates in AN may be partially explained by AN patients' higher desire to die and their more severe and lethal attempts.
authors.affiliation: Inserm, U1061, Montpellier, France. guillaumesebastien@ymail.com
authors.forename: Sébastien
authors.initials: S
authors.lastname: Guillaume
authors.forename: Isabelle
authors.initials: I
authors.lastname: Jaussent
authors.forename: Emilie
authors.initials: E
authors.lastname: Olié
authors.forename: Catherine
authors.initials: C
authors.lastname: Genty
authors.forename: Jacques
authors.initials: J
authors.lastname: Bringer
authors.forename: Philippe
authors.initials: P
authors.lastname: Courtet
authors.forename: Ulrike
authors.initials: U
authors.lastname: Schmidt
mesh_terms: D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000523:psychology*; D052018:Bulimia Nervosa / Q000469:parasitology*; D016022:Case-Control Studies; D015331:Cohort Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004522:Educational Status; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult