title: Suicide attempts in women with eating disorders.
abstract: We evaluated whether the prevalence of lifetime suicide attempts/completions was higher in women with a lifetime history of an eating disorder than in women with no eating disorder and assessed whether eating disorder features, comorbid psychopathology, and personality characteristics were associated with suicide attempts in women with anorexia nervosa, restricting subtype (ANR), anorexia nervosa, binge-purge subtype (ANBP), lifetime history of both anorexia nervosa and bulimia nervosa (ANBN), bulimia nervosa (BN), binge eating disorder (BED), and purging disorder (PD). Participants were part of the Swedish Twin study of Adults: Genes and Environment (N = 13,035) cohort. Lifetime suicide attempts were identified using diagnoses from the Swedish National Patient and Cause of Death Registers. General linear models were applied to evaluate whether eating disorder category (ANR, ANBP, ANBN, BN, BED, PD, or no eating disorder [no ED]) was associated with suicide attempts and to identify factors associated with suicide attempts. Relative to women with no ED, lifetime suicide attempts were significantly more common in women with all types of eating disorder. None of the eating disorder features or personality variables was significantly associated with suicide attempts. In the ANBP and ANBN groups, the prevalence of comorbid psychiatric conditions was higher in individuals with than without a lifetime suicide attempt. The odds of suicide were highest in presentations that included purging behavior (ANBN, ANBN, BN, and PD), but were elevated in all eating disorders. To improve outcomes and decrease mortality, it is critical to be vigilant for suicide and identify indices for those who are at greatest risk.
authors.affiliation: Department of Psychiatry, University of North Carolina at Chapel Hill.
authors.forename: Emily M
authors.initials: EM
authors.lastname: Pisetsky
authors.affiliation: Department of Psychiatry, University of North Carolina at Chapel Hill.
authors.forename: Laura M
authors.initials: LM
authors.lastname: Thornton
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet.
authors.forename: Paul
authors.initials: P
authors.lastname: Lichtenstein
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet.
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Pedersen
authors.affiliation: Department of Psychiatry, University of North Carolina at Chapel Hill.
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Bulik
mesh_terms: D000328:Adult; D017668:Age of Onset; D015897:Comorbidity; D004200:Diseases in Twins; D001068:Feeding and Eating Disorders / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology; D015995:Prevalence; D013405:Suicide / Q000706:statistics & numerical data*; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult