Having an Eating Disorder Increases Risk of Suicide

Suicide is a deadly byproduct of eating disorders. Until recently no study has established the extent to which suicidality is uniquely associated with an eating disorder rather than attributed to comorbid mood, anxiety, or substance use disorders.  Three psychologists at Florida State University recently found that bulimia nervosa (BN), but not other eating disorders, was independently associated with suicidality (J Psychiatr Res.2013 Feb 2 [Epub ahead of print]).

Lindsey P. Bodell, TE Joiner, and Pamela Keel used the Structured Clinical Interview for Axis I diagnoses (SCID-1) to determine lifetime psychiatric diagnoses and lifetime suicidality among 364 women selected from the second stage of a large epidemiological study examining eating- and health-related attitudes and behaviors.

Using a multiple regression model including eating and comorbid disorders, the researchers found that BN was significantly associated with suicidality above and beyond risk predicted by the presence of comorbid disorders.  No such unique association was found for women with AN or eating disorders not otherwise specified (EDNOS).

NIMH study also links risk with bulimic behavior in teens

The greater risk for suicidality among bulimic patients was also found in an earlier National Institutes of Mental Health study of 10,123 adolescents 13 to 18 years of age (Arch Gen Psychiatry. 2011 68:714). Sonja Swanson and colleagues first established that adolescents with eating disorders had higher rates of suicidal ideation, planning, and attempts than did their peers without eating disorders. The rates of behavior linked to suicidal thoughts and attempts were startling: suicidal thoughts were reported by one-third of teens with AN, one-third with binge eating disorder (BED), and more than half of those with BN.  Slightly more than 10% of teens without eating disorders reported having suicidal thoughts.

The rates of suicidal attempts were also high.  While 3% of teens without eating disorders had made suicide attempts, about 35% of those with BN, 8% with AN, and 15% for those with BED reported such attempts.

In an Italian study, women were affected more often

A study in northeastern Italy examined a community sample of 1000 adolescents 15 to 19 years of age to investigate possible links between eating disorders and suicidal tendencies (J Nerv Ment Dis. 2003; 191:437). Dr. Paola Miotta and collates used self-report questionnaires, including the Eating Attitudes Test (EAT), the Bulimic Investigatory Test of Edinburgh (BITE), the Body Attitudes Test (BAT), and the Symptom Checklist-90 (revised) (SCL-90-R).

More females than males reported abnormal eating patterns, and more females than males also reported symptoms of hopelessness, 44.3% vs. 30.5%, respectively, and suicidal ideation, 30.8% vs. 25.3%, respectively. Both males and females reporting suicidal ideation had significantly higher scores on all the eating disorders inventories.