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

Abstract

BED, comorbid disorders, and suicidality share common factors and interrelations, and individuals with BED and comorbid disorders may be at particularly high risk for suicidal outcomes. The presence of BED in adolescence may serve as a marker for more severe symptomatology that precedes the occurrence of suicidality. Research is needed to understand how eating disorder symptoms, comorbid symptoms, and suicidality affect one another over time. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2017; 50:40-49).

The Relationship between Binge Eating Disorder and Suicidality: A Systematic Review

“…Among the studies investigating the associations between suicidality and BED, seven papers (Ackard et al, 2003 , 2011 ; Swanson et al, 2011 ; Carano et al, 2012 ; Izydorczyk and Mazur, 2012 ; Portzky et al, 2014 ; Forrest et al, 2017 ) reported data on SI, whereas 16 papers reported data on SA and suicide completion in individuals with BED (Ackard et al, 2003 , 2011 ; Grucza et al, 2007 ; Chen et al, 2008 ; McElroy et al, 2011 , 2016 ; Swanson et al, 2011 ; Carano et al, 2012 ; Izydorczyk and Mazur, 2012 ; Pisetsky et al, 2013 ; Portzky et al, 2014 ; Runfola et al, 2014 ; Suokas et al, 2014 ; Annagur et al, 2015 ; Forrest et al, 2017 ; Welch et al, 2016 ). By examining the results of these studies, it was observed that the prevalence of SI varied between 26.3% (Ackard et al, 2003 ) and 51.7% (Portzky et al, 2014 ), and that the rates of SA and suicide completion varied between 2.3% (Suokas et al, 2014 ) and 34% (McElroy et al, 2016 ).…”

“…A total of 34.4% of the adolescents who met the criteria for BED reported SI, 15.1% had attempted suicide, and 5.1% had planned suicide. Moreover, it is important to highlight that in a subsequent and more recent paper (Forrest et al, 2017 ), this sample of adolescents was compared with 2,980 adults. This more recent study found that BED was associated with significantly elevated odds of SI among adolescents aged 13–18 (OR 3.81) and adults aged 18–29 (OR 4.05); BED was also associated with significantly elevated odds of suicide planning among adults (ORs 3.46–5.92) and of SA among adolescents (OR 5.01) and adults aged 18–29 (OR 4.64) and 45–59 (OR 4.96).…”

Are Eating Disorders and Related Symptoms Risk Factors for Suicidal Thoughts and Behaviors? A Meta‐analysis

“…In fact, to our knowledge, very little research has closely examined the time course between the onset of an eating disorder and the onset of suicidality. One recent study found that within adults, suicidality typically onset before the onset of binge eating; however, this pattern was reversed in adolescents (Forrest, Zuromski, Dodd, & Smith, ). Additional research examining the mean length of time between onset of eating disorder symptoms and suicidality is needed.…”

“…For instance, acute exacerbations in symptoms (e.g., dramatic and uncharacteristic changes in weight or compensatory behaviors over a brief period of time, increases in activity/agitation) may be important to consider (Ribeiro, Silva, & Joiner, 2014;Ribeiro, Yen, Joiner, & Siegler, 2015). Additionally, future researchers may wish to examine factors relevant to ED populations, such as interoceptive deficits (feeling disconnected from one's body), which have been found to be related to attempts in ED (Smith, Forrest, & Velkoffin, in press) and other populations (Forrest, Smith, White, & Joiner, 2015). It will also be important for future research to examine the specific effects of individual ED symptoms on suicidality over time; we were unable to conduct these finer-grained analyses due to the limited number of available studies.…”

Diagnosis‐specific self‐image predicts longitudinal suicidal ideation in adult eating disorders

“…Little previous research concerning suicidality in ED has included BED, and previous attempts at identifying predictors have been negative or inconclusive (Pisetsky et al, ). In a recent study, the increased risk of suicidality (ideation, plan or attempt) observed in individuals with BED did not remain when adjustment was made for comorbid psychopathology, and the authors suggested that some underlying, transdiagnostically relevant risk factor might be responsible, such as body dissatisfaction, interoceptive deficits or emotion dysregulation (Forrest, Zuromski, Dodd, & Smith, ). In another SASB‐based study, it was shown that self‐blame was consistently related to ED symptoms in normal and non‐clinical but highly symptomatic samples, as well as clinical groups across ED diagnoses (Forsén Mantilla & Birgegård, ).…”