Common and differential risk factors behind suicidal behavior in patients with impulsivity-related disorders: The case of bulimic spectrum eating disorders and gambling disorder

Abstract

Background and aims Mental disorders with high levels of impulsivity such as bulimic spectrum eating disorders (BSED) and gambling disorder (GD) are associated with high risk of suicidal behavior. The aim of the present study was to identify the common and differential vulnerability factors behind suicide attempts in a sample of patients with BSED compared to patients with GD. Methods A total of 6,077 adults who sought treatment and met criteria either for BSED (n = 2,391) or GD (n = 3,686) were assessed at a specialized hospital unit. Personality traits, psychopathological symptomatology, lifetime history of suicide attempts and socio-demographic variables were evaluated. Results The prevalence of suicide attempts was higher for BSED patients (26.2%) compared to GD patients (7.1%) being anorexia nervosa (Binge/Purge type) and bulimia nervosa the most affected subtypes. In the predictive model, the transdiagnostic vulnerability factors with the highest contribution to the risk of suicidal behavior both in BSED and GD were unemployment, early age of onset of the disorder, worse psychopathological state, and self-transcendence personality trait. However, specific risk factors for suicidal acts were identified in each disorder: longer duration of the disorder, lower education levels and reward dependence were exclusively associated with BSED while female gender, older age, and higher harm avoidance were associated with GD. Discussion Patients with GD and BSED share certain vulnerability factors although certain factors are exclusive to each disorder. Conclusions Interventions need to pay special attention to both common and specific vulnerability factors to mitigate the risk of suicidal acts in these disorders.

Impulsivity and compulsivity in gambling disorder and bulimic spectrum eating disorders: Analysis of neuropsychological profiles and sex differences

“…Gambling disorder (GD) and eating disorders (EDs) are mental conditions characterised by persistent maladaptive patterns of gambling behaviour and abnormal eating, respectively [1]. Despite representing very different entities with specific clinical symptoms, these disorders share numerous psychopathological, neurobiological, and comorbidity features [2][3][4][5][6]. For instance, both disorders are distinguished by elevated behavioural disinhibition [7,8], great levels of negative urgency [9,10], as well as difficulties in executive function [11] and emotion regulation [5].…”

“…a Significant comparison (.05 level). b Effect size into the range mild-moderate (|h| or |d| higher than 0.50) to high-large (|h| or |d| higher than 0.80) 4. Lozano-Madrid et al…”