What predicts suicide attempts in women with eating disorders?

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.

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Twelve-year course and outcome of bulimia nervosa

Psychological Medicine ◽

10.1017/s0033291704002673 ◽

2004 ◽

Vol 34 (8) ◽

pp. 1395-1406 ◽

Cited By ~ 102

Author(s):

MANFRED M. FICHTER ◽

NORBERT QUADFLIEG

Keyword(s):

Eating Disorders ◽

Anorexia Nervosa ◽

Eating Disorder ◽

Bulimia Nervosa ◽

General Pattern ◽

Prospective Longitudinal Study ◽

End Of Treatment ◽

Co Morbidity ◽

Prospective Longitudinal

Background. Since little is known about the long-term course and outcome of bulimia nervosa, the authors designed a 12-year prospective longitudinal study with five cross-sectional assessments based on a large sample of consecutively treated females with bulimia nervosa (purging type) (BN-P).Method. One hundred and ninety-six females with BN-P were assessed (1) at the beginning of treatment, (2) at the end of treatment, (3) at 2-year follow-up, (4) at 6-year follow-up, and (5) at 12-year follow-up. In self-ratings as well as expert ratings based on interviews we assessed specific eating-disorder and general psychopathology.Results. The general pattern of results over time showed substantial improvement during treatment, slight (in most cases non-significant) decline during the first two years after the end of treatment, and further improvement and stabilization until 12-year follow-up. At that point the majority of patients (70·1%) showed no major DSM-IV eating disorder, 13·2% had eating disorders not otherwise specified, 10·1% had BN-P and 2% had died. Very few had undergone transition to anorexia nervosa or binge-eating disorders. Logistic regression analyses showed that psychiatric co-morbidity was the best and most stable predictor for eating-disorder outcome at 2, 6 and 12 years.Conclusions. Course and outcome of BN-P was generally more favourable than for anorexia nervosa.

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Substance abuse and psychiatric co-morbidity as predictors of premature mortality in Swedish drug abusers a prospective longitudinal study 1970 - 2006

BMC Psychiatry ◽

10.1186/1471-244x-11-122 ◽

2011 ◽

Vol 11 (1) ◽

Cited By ~ 38

Author(s):

Anna Nyhlén ◽

Mats Fridell ◽

Martin Bäckström ◽

Morten Hesse ◽

Peter Krantz

Keyword(s):

Substance Abuse ◽

Longitudinal Study ◽

Premature Mortality ◽

Drug Abusers ◽

Prospective Longitudinal Study ◽

Co Morbidity ◽

Prospective Longitudinal

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Personality trait risk factors for attempted suicide among young women with eating disorders

European Psychiatry ◽

10.1016/j.eurpsy.2003.11.005 ◽

2004 ◽

Vol 19 (3) ◽

pp. 131-139 ◽

Cited By ~ 32

Author(s):

G. Youssef ◽

B. Plancherel ◽

J. Laget ◽

M. Corcos ◽

M.F. Flament ◽

...

Keyword(s):

Eating Disorders ◽

Anorexia Nervosa ◽

Bulimia Nervosa ◽

Young Women ◽

Suicidal Behaviour ◽

Minnesota Multiphasic Personality Inventory ◽

Suicide Attempts ◽

Risk Indicators ◽

Control Group ◽

Clinical Group

AbstractObjectiveClinical observations and a review of the literature led us to hypothesize that certain personality and character traits could provide improved understanding, and thus improved prevention, of suicidal behaviour among young women with eating disorders.MethodThe clinical group consisted of 152 women aged between 18 and 24 years, with DSM-IV anorexia nervosa/restrictive type (AN-R = 66), anorexia nervosa/purging type (AN-P = 37), bulimia nervosa/non-purging type (BN-NP = 9), or bulimia nervosa/purging type (BN-P = 40). The control group consisted of 140 subjects. The assessment measures were the Minnesota Multiphasic Personality Inventory—second version (MMPI-2) scales and subscales, the Beck Depression Inventory (BDI) used to control for current depressive symptoms, plus a specific questionnaire concerning suicide attempts.ResultsSuicide attempts were most frequent in subjects with purging behaviour (30.0% for BN-P and 29.7% for AN-P). Those attempting suicide among subjects with eating disorders were mostly students (67.8%). For women with AN-R the scales for ‘Depression’ and ‘Antisocial practices’ represented significant suicidal risk, for women with AN-P the scales for ‘Hysteria’, ‘Psychopathic deviate’, ‘Shyness/Self-consciousness’, ‘Antisocial Practices’, ‘Obsessiveness’ and ‘Low self-esteem’ were risk indicators and for women with BN-P the ‘Psychasthenia’, ‘Anger’ and ‘Fears’ scales were risk indicators.ConclusionThis study provides interesting results concerning the personality traits of young women with both eating disorders and suicidal behaviour. Students and those with purging behaviour are most at risk. Young women should be given more attention with regard to the risk of suicide attempts if they: (a) have AN-R with a tendency to self-punishment and antisocial conduct, (b) have AN-P with multiple physical complaints, are not at ease in social situations and have antisocial behaviour, or (c) if they have BN-P and tend to be easily angered with obsessive behaviour and phobic worries. The MMPI-2 is an interesting assessment method for the study of traits indicating a risk of suicidal behaviour in young subjects, after controlling for current depressive pathology.

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