title: Suicide attempts and mortality in eating disorders: a follow-up study of eating disorder patients.
abstract: OBJECTIVE
  The aim of this study is to explore the prevalence of hospital-treated suicide attempts in a large clinical population of eating disorder patients.
  
  
  METHODS
  Follow-up study of adults (N=2462, 95% women, age 18-62 years) admitted to the Eating Disorder Clinic of Helsinki University Central Hospital in the period 1995-2010. For each patient, four controls were selected and matched for age, sex and place of residence. The end point events were modeled using Cox's proportional hazard model, taking matching into account.
  
  
  RESULTS
  We identified 156 patients with eating disorder (6.3%) and 139 controls (1.4%) who had required hospital treatment for attempted suicide. Of them, 66 (42.3%) and 37 (26.6%) had more than one attempt. The rate ratio (RR) for suicide attempt in patients with eating disorder was 4.70 [95% confidence interval (CI) 1.41-15.74]. In anorexia nervosa, RR was 8.01 (95% CI 5.40-11.87), and in bulimia nervosa, it was 5.08 (95% CI 3.46-7.42). In eating disorder patients with a history of suicide attempt, the risk of death from any cause was 12.8%, suicide being the main cause in 45% of the deaths.
  
  
  CONCLUSIONS
  Suicide attempts and repeated attempts are common among patients with eating disorders. Suicidal ideation should be routinely assessed from patients with eating disorders.
authors.affiliation: Department of Psychiatry, Helsinki University Central Hospital, Finland; Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland. Electronic address: jaana.suokas@hus.fi.
authors.forename: Jaana T
authors.initials: JT
authors.lastname: Suokas
authors.affiliation: Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland; Department of Social Psychiatry, Tampere School of Public Health, Finland.
authors.forename: Jaana M
authors.initials: JM
authors.lastname: Suvisaari
authors.affiliation: Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Marjut
authors.initials: M
authors.lastname: Grainger
authors.affiliation: Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland; National Institute for Health and Welfare, Helsinki, Finland; Nordic School of Public Health, Gothenburg, Sweden; Hjelt Institute, Department of Public Health, University of Helsinki, Finland.
authors.forename: Anu
authors.initials: A
authors.lastname: Raevuori
authors.affiliation: Department of Adolescent Psychiatry, Helsinki University Central Hospital, Helsinki, Finland; Institute of Clinical Medicine, Child Psychiatry, University Of Turku, Finland.
authors.forename: Mika
authors.initials: M
authors.lastname: Gissler
authors.affiliation: Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland; National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Jari
authors.initials: J
authors.lastname: Haukka
mesh_terms: D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000453:epidemiology / Q000401:mortality; D052018:Bulimia Nervosa / Q000453:epidemiology / Q000401:mortality; D001068:Feeding and Eating Disorders / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D013406:Suicide, Attempted / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Eating disorder; Follow-up; Mortality; Suicide; Suicide attempt