Suicidal behaviour and nonsuicidal self-injury among patients with eating disorders

Author(s):  
Judit Balazs ◽  
Lili Olga Horvath

Eating disorders (EDs), especially anorexia nervosa (AN), bulimia nervosa (BN), and binge-eating disorder (BED) often co-occur with suicidal behaviour and non-suicidal self-injury (NSSI). The shared epidemiological and risk factors of EDs, suicidal behaviour, and NSSI include the self-destructive and body-focused characteristics of these behaviours; body dissatisfaction, interoceptive deficits, emotion dysregulation, impulsivity, and several environmental risk factors. Compared to the general population, lifetime rates of suicidal ideation, suicide attempts, and NSSI are increased among patients with AN, BN, or BED. Risk factors play a role in the development of suicidal behaviour in patients with EDs, including comorbid psychopathology that is associated with an increased risk of suicide itself, increased impulsive behaviours including NSSI, the duration of illness, and the number of previous treatments. Being aware of the increased risk and the ED-specific risk factors of suicidal behaviour are essential for preventing suicide and treating clinical risk factors in patients with EDs.

Author(s):  
Nav Kapur ◽  
Sarah Steeg ◽  
Adam Moreton

Self-harm—mainly self-poisoning and self-injury—is an important cause of presentation to health services internationally. The annual incidence worldwide is likely to be in the region of 4 per 1000 adults, with a lifetime prevalence of between 3% and 5% in Western countries. Self-harm is more common in young people and more common in girls than boys. Self-harm has a complex aetiology, with sociodemographic, clinical, environmental, and genetic factors all contributing. It is associated with a greatly increased risk of suicide and death by other causes—1 in 50 people die by suicide in the year after hospital presentation for self-harm. Models of suicidal behaviour may help us to understand how different risk factors link together, but risk scales are unlikely to be useful in practice because of their limited predictive value.


2021 ◽  
Author(s):  
Prianka Padmanathan ◽  
Danielle Lamb ◽  
Hannah Scott ◽  
Simon Wessely ◽  
Paul Moran

AbstractIntroductionThere have been longstanding concerns regarding an increased risk of suicide amongst healthcare workers. The Covid-19 pandemic has placed an additional burden on staff, yet few studies have investigated the impact of the pandemic on their risk of suicide and self-harm. We aimed to investigate the cumulative incidence, prevalence and correlates of suicidal ideation, suicide attempts and non-suicidal self-injury amongst healthcare workers during the Covid-19 pandemic.Methods and AnalysisNHS Check is an online survey that was distributed to all staff (clinical and non-clinical), students, and volunteers in 18 NHS Trusts across England during the Covid-19 pandemic. Data collected in wave 1 (collected between April 2020 and January 2021) and wave 2 (collected 6-month after wave 1) will be analysed. The full cohort of wave 1 participants will be weighted to represent the age, sex, ethnicity, and roles profile of the workforce at each Trust, and the weighted prevalence and cumulative incidence of suicidal ideation, suicide attempts and non-suicidal self-injury will be described. Two-level random effects logistic regression models will be used to investigate the relationship between suicidal behaviour and self-harm, and demographic characteristics (age, sex, ethnicity) and workplace factors (concerns regarding access to personal protective equipment, re-deployment status, moral injury, confidence around raising and the management of safety concerns, support by supervisors or managers, satisfaction with standard of care provided). Results will be stratified by role (clinical/non-clinical).


2018 ◽  
Vol 49 (5) ◽  
pp. 1220-1231 ◽  
Author(s):  
Sandra Pérez ◽  
Montserrat Cañabate Ros ◽  
Jose E. Layron Folgado ◽  
Jose H. Marco

2016 ◽  
Vol 46 (7) ◽  
pp. 1345-1358 ◽  
Author(s):  
A. Cucchi ◽  
D. Ryan ◽  
G. Konstantakopoulos ◽  
S. Stroumpa ◽  
A. Ş. Kaçar ◽  
...  

BackgroundAgainst a backdrop of increasing research, clinical and taxonomic attention in non-suicidal self-injury (NSSI), evidence suggests a link between NSSI and eating disorders (ED). The frequency estimates of NSSI in ED vary widely. Little is known about the sources of this variation, and no meta-analysis has quantified the association between ED and NSSI.MethodUsing random-effects meta-analyses, meta-regression analyses, and 1816–6466 unique participants with various ED, we estimated the weighted average percentage of individuals with ED, those with anorexia nervosa (AN) and those with bulimia nervosa (BN) who are reported to have a lifetime history of NSSI across studies. We further examined predictors of NSSI in ED.ResultsThe weighted average percentage of patients with a lifetime history of NSSI was 27.3% [95% confidence interval (CI) 23.8–31.0%] for ED, 21.8% (95% CI 18.5–25.6%) for AN, and 32.7% (95% CI 26.9–39.1%) for BN. The difference between BN and AN was statistically significant [odds ratio (OR) 1.77, 95% CI 1.14–2.77, p = 0.013]. The odds of NSSI increased by 24% for every 10% increase in the percentage of participants with histories of suicide attempts (OR 1.24, 95% CI 1.04–1.48, p = 0.020) and decreased by 26% for every 10% increase in the percentage of participants with histories of substance abuse (OR 0.74, 95% CI 0.58–0.95, p = 0.023).ConclusionsIn the specific context of ED, NSSI is highly prevalent and correlates positively with attempted suicide, urging for NSSI-focused treatments. A novel finding is that NSSI is potentially antagonized by substance abuse.


Author(s):  
Margaret S. Andover ◽  
Heather T. Schatten ◽  
Blair W. Morris

Individuals diagnosed with borderline personality disorder (BPD) are at an elevated risk for engaging in self-injurious behaviors, including suicide, attempted suicide, and nonsuicidal self-injury (NSSI). The purpose of this chapter is to provide an overview of research on self-injurious behaviors among individuals with BPD. Definitions and prevalence rates are provided for NSSI, suicide, and attempted suicide. Clinical correlates of and risk factors for the behaviors, as well as associations between specific BPD criteria and self-injurious behaviors, are discussed, and a brief overview of treatments focused on reducing self-injurious behaviors among BPD patients is provided. By understanding risk factors for attempted suicide and NSSI in BPD, we can better identify patients who are at increased risk and focus treatment efforts on addressing modifiable risk factors.


2015 ◽  
Vol 54 (1) ◽  
pp. 58-65 ◽  
Author(s):  
Suzana Pustivšek ◽  
Vedran Hadžić ◽  
Edvin Dervišević

Abstract Objective. Eating disorders (ED) are an important and increasing problem in adolescents. The objective of this study was to examine the risk factors and the prevalence of risk for ED among male adolescent elite athletes and nonathletic controls. Differences between male athletes competing in aerobic, anaerobic and aerobic-anaerobic sports were examined as well. Methods. This was a cross-sectional epidemiological study. A cross-sectional questionnaire survey and anthropometric measurements were conducted on 351 adolescents (athletes n = 228; controls n = 123). All participants were aged 15-17 at the time of measuring. Risk for ED was determined using a SCOFF questionnaire. Results. The overall prevalence of the risk for ED in male adolescents was 24.8%, with no significant differences among athletes and controls or different subgroups of athletes (p>0.05), although the highest prevalence (37.2%) was registered in aerobic subgroup of athletes. Higher number of attempts to lose weight was associated with increased risk of ED in each group (athletes and controls). Other predictors referred to lack of breakfast and body composition in aerobic subgroup of athletes and number of meals and training frequency in anaerobic subgroup. The most common reasons for dieting were improvement of sport results (19.6-44.2%) and better self-esteem (41.5%) in athletes and controls respectively. Conclusions. Participation in the competitive sport itself is not associated with the increased risk for ED. It seems that risk factors for ED for adolescent athletes competing in aerobic and anaerobic sports represent a subject that deserves consideration and further investigation in the future


2016 ◽  
Vol 209 (4) ◽  
pp. 319-326 ◽  
Author(s):  
Yongsheng Tong ◽  
Michael R. Phillips ◽  
Kenneth R. Conner

BackgroundThere are meagre data on Axis II personality disorders and suicidal behaviour in China.AimsTo describe the prevalence of Axis II personality disorders in suicides and suicide attempts in China and to estimate risk for these outcomes associated with personality disorders.MethodPeople who died by suicide (n = 151), people who attempted suicide (n = 118) and living community controls (n = 140) were randomly sampled from four Chinese counties and studied using the Structured Clinical Interviews for DSM-IV-TR Axis I Disorders (SCID-I) and Axis II Personality Disorders (SCID-II). We also determined the prevalence of subthreshold versions of ten DSM-IV personality disorders.ResultsAxis II personality disorders were present in 7% of the suicide group, 6% of the suicide attempt group and 1% of the control group. Threshold and subthreshold personality disorders had adjusted odds ratios (point estimates) in the range of 2.7–8.0 for suicide and for suicide attempts.ConclusionsAxis II personality disorders may confer increased risk for suicidal behaviour in China, but their low prevalence in the community and among people with suicidal behaviour suggests that other personality constructs such as select dimensional traits may be a more fruitful avenue for understanding and preventing suicide in China.


2021 ◽  
Author(s):  
Ian Burton

Eating disorders (ED) are serious mental disorders, which can have serious health consequences and high mortality rates. Due to facing unique risk factors female athletes have increased susceptibility for ED. Female athletes are also at risk for subclinical conditions such as the Female Athlete Triad. There is a dearth of studies on preventing and identifying ED in female athletes and the role and responsibility of the sports coach is unclear. This study aimed to address the questions of whether female athletes are at increased risk for ED, what interventions currently show promise and what is the role of the sports coach in the intervention process. The study was based on a systematic review of relevant literature retrieved through PubMed and Sports Discus databases. Despite heterogeneity in prevalence studies, findings suggest that female athletes are at higher risk than male athletes and non-athletes and those in elite level sports or sports categorised as lean, aesthetic, endurance and weight-class are at increased risk for clinical and subclinical ED. Risk-factors unique to the sports environment such as weight pressures, competitive thinness and revealing uniforms, may lead to increased risk in female athletes. Despite a dearth of studies on interventions for ED in sport, findings suggest that primary prevention programs based on educating athletes such as ATHENA show most promise in prevention. Secondary prevention should focus on early identification using athlete-specific screening tools. Symptom checklists and pre-participation examinations can also assist coaches in early identification. Psychotherapy interventions such as CBT have had the best results for treatment. Sports coaches’ play a critical role in, early identification, referral, management and prevention of ED in female athletes. However, current findings suggest that many coaches lack knowledge about ED and require education to be able to intervene successfully in female athletes with ED. Inappropriate coaching behaviours have also been found to act as an additional risk-factor for ED. Recommendations for sports coaches in N.I. are provided to assist them in successful intervention, management and return to play of female athletes with ED.


2015 ◽  
Vol 18 ◽  
Author(s):  
Pablo Ruisoto ◽  
Raúl Cacho ◽  
José J. López-Goñi ◽  
Eulogio Real Deus ◽  
Silvia Vaca ◽  
...  

AbstractSome females are at an increased risk of developing bulimia. However, etiological factors and their interplay remain controversial. The present study analyzed Sticefe Model for eating disorders in a non-clinical population by examining gender differences with respect to the following risk factors: body mass index (BMI), body dissatisfaction, perceived social pressure to be thin, body-thin internalization, and dieting behavior. A sample of 162 American college students (64 males and 91 females) was surveyed, and validated scales were used. The Sticey model was tested using Structural Equation Modeling. Our results supported Stice r Dual Pathway Model of bulimic pathology for females but not for males. Females reported significantly higher body dissatisfaction, perceived pressure to be thin and weight-loss oriented behaviors than males (p < .05), but no gender differences were found in their degree of body thin internalization (p > .05), a key predictor of body dissatisfaction (r = .33; p < .01). Participants with higher BMI reported greater social pressure to be thin than those with lower BMI (p < .05). However, females engaged in dietary restraint, the main risk factor for eating disorders, regardless of their BMI (p > .05) although their BMI was significantly lower than males (d = 0,51). The results of this study fail to support the role of BMI as a predictor of dietary restraint in females, the main risk factor of eating disorders. Males may abstain from dietary restraint to gain muscular volume and in turn increase their BMI. Implications are discussed.


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