Psychological Medicine



What predicts suicide attempts in women with eating disorders?


D. L. FRANKO a1c1, P. K. KEEL a1, D. J. DORER a1, M. A. BLAIS a1, S. S. DELINSKY a1, K. T. EDDY a1, V. CHARAT a1, R. RENN a1 and D. B. HERZOG a1
a1 Harvard Eating Disorders Center, Massachusetts General Hospital, Boston, MA, USA; Department of Counseling & Applied Educational Psychology, Northeastern University; Harvard University; and Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA

Article author query
franko dl   [PubMed][Google Scholar] 
keel pk   [PubMed][Google Scholar] 
dorer dj   [PubMed][Google Scholar] 
blais ma   [PubMed][Google Scholar] 
delinsky ss   [PubMed][Google Scholar] 
eddy kt   [PubMed][Google Scholar] 
charat v   [PubMed][Google Scholar] 
renn r   [PubMed][Google Scholar] 
herzog d   [PubMed][Google Scholar] 

Abstract

Background. Suicide is a common cause of death in anorexia nervosa and suicide attempts occur often in both anorexia nervosa and bulimia nervosa. No studies have examined predictors of suicide attempts in a longitudinal study of eating disorders with frequent follow-up intervals. The objective of this study was to determine predictors of serious suicide attempts in women with eating disorders.

Method. In a prospective longitudinal study, women diagnosed with either DSM-IV anorexia nervosa (n=136) or bulimia nervosa (n=110) were interviewed and assessed for suicide attempts and suicidal intent every 6–12 months over 8·6 years.

Results. Fifteen percent of subjects reported at least one prospective suicide attempt over the course of the study. Significantly more anorexic (22·1%) than bulimic subjects (10·9%) made a suicide attempt. Multivariate analyses indicated that the unique predictors of suicide attempts for anorexia nervosa included the severity of both depressive symptoms and drug use over the course of the study. For bulimia nervosa, a history of drug use disorder at intake and the use of laxatives during the study significantly predicted suicide attempts.

Conclusions. Women with anorexia nervosa or bulimia nervosa are at considerable risk to attempt suicide. Clinicians should be aware of this risk, particularly in anorexic patients with substantial co-morbidity.


Correspondence:
c1 Dr Debra L. Franko, Harvard Eating Disorders Center, Massachusetts General Hospital, WACC 725, 15 Parkman St, Boston, MA 02114, USA. (Email: d.franko@neu.edu)


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