Comorbidity-independent risk for suicidality increases with bulimia nervosa but not with anorexia nervosa

Abstract

Background Eating disorders are serious psychiatric illnesses with high levels of suicidality and high comorbidity. However, no study has established the extent to which suicidality is uniquely associated with eating disorders rather than attributable to comorbid mood, anxiety, or substance use disorders. The current study examined whether unique associations between eating disorders and suicidality exist and whether potential associations differ by eating disorder diagnosis. Methods Participants were women (n=364) from the second stage of a large epidemiological study examining eating and health related attitudes and behaviors. The Structured Clinical Interview for Axis I diagnoses (SCID-I) was used to determine lifetime psychiatric diagnoses and lifetime suicidality. Results A multiple regression model including eating and comorbid disorders indicated that bulimia nervosa (BN) was significantly associated with suicidality above and beyond risk predicted by comorbid disorders. No unique association was found for anorexia nervosa (AN) or eating disorder not otherwise specified while controlling for comorbidity. Conclusions BN is independently associated with suicidality, and findings emphasize the need to incorporate suicide risk assessment in standardized assessments of eating disorders.

Co-Rumination of Fat Talk and Weight Control Practices: An Application of Confirmation Theory

“…This effect is new to the literature. Binging and purging are key indicators of bulimia nervosa, which is a clinical eating disorder and significant public health issue (e.g., American Psychiatric Association, 2013; Bodell, Joiner, & Keel, 2013). In this case, where negative self-perceptions drive fat talk (Sharpe, Naumann, Treasure, & Schmidt, 2013) and negative self-perceptions are subsequently associated with disordered eating attitudes (Arroyo & Segrin, 2013), supportive messages that consist of warmth and positive regard may mitigate the impact of fat talk by providing the necessary support needed to promote healthy behaviors/thoughts and reduce its health-damaging effects.…”

Suicidality in adolescents and adults with binge‐eating disorder: Results from the national comorbidity survey replication and adolescent supplement

“…This study used population‐based surveys to (1) assess the association between lifetime EDs (i.e., BED, BN, and AN) and suicide ideation, planning, and attempting, specifically investigating suicide risk in BED, and (2) examine the temporal association between the ages of onset of BED and suicide ideation, planning, and attempting. BED and BN share many symptoms, and given that previous research indicates that AN and BN are associated with elevated suicide risk beyond that accounted for by comorbid mood, anxiety, and substance use disorders, we predicted that lifetime BED would be associated with suicide risk when adjusting for comorbid disorders. Given that BN typically onsets before suicidality, we predicted that BED would onset before suicidality.…”

Restraint feeds stress: The relationship between eating disorder symptoms, stress generation, and the interpersonal theory of suicide

“…This increased mortality risk can be partially attributed to an elevated risk for death by suicide among individuals with eating disorders (Arcelus, Mitchell, Wales, & Nielsen, 2011; Bodell, Joiner, & Keel, 2013; Crow et al, 2009; Preti, Rocchi, Sisti, Camboni, & Miotto, 2011). Risk for death by suicide is particularly elevated among individuals with anorexia nervosa (AN).…”