Department of Psychiatry, University of North Carolina at Chapel Hill.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet.
J Abnorm Psychol. 2013 Nov;122(4):1042-56. doi: 10.1037/a0034902.
We evaluated whether the prevalence of lifetime suicide attempts/completions was higher in women with a lifetime history of an eating disorder than in women with no eating disorder and assessed whether eating disorder features, comorbid psychopathology, and personality characteristics were associated with suicide attempts in women with anorexia nervosa, restricting subtype (ANR), anorexia nervosa, binge-purge subtype (ANBP), lifetime history of both anorexia nervosa and bulimia nervosa (ANBN), bulimia nervosa (BN), binge eating disorder (BED), and purging disorder (PD). Participants were part of the Swedish Twin study of Adults: Genes and Environment (N = 13,035) cohort. Lifetime suicide attempts were identified using diagnoses from the Swedish National Patient and Cause of Death Registers. General linear models were applied to evaluate whether eating disorder category (ANR, ANBP, ANBN, BN, BED, PD, or no eating disorder [no ED]) was associated with suicide attempts and to identify factors associated with suicide attempts. Relative to women with no ED, lifetime suicide attempts were significantly more common in women with all types of eating disorder. None of the eating disorder features or personality variables was significantly associated with suicide attempts. In the ANBP and ANBN groups, the prevalence of comorbid psychiatric conditions was higher in individuals with than without a lifetime suicide attempt. The odds of suicide were highest in presentations that included purging behavior (ANBN, ANBN, BN, and PD), but were elevated in all eating disorders. To improve outcomes and decrease mortality, it is critical to be vigilant for suicide and identify indices for those who are at greatest risk.
我们评估了有终身饮食障碍史的女性中，终身自杀企图/完成的发生率是否高于无饮食障碍的女性，并评估了饮食障碍特征、共病精神病理学和人格特征是否与神经性厌食症、限制型（ANR）、神经性贪食症、暴食-清除型（ANBP）、神经性贪食症和神经性贪食症（ANBN）、神经性贪食症（BN）、暴食障碍（BED）和清除障碍（PD）的女性自杀企图有关。参与者是瑞典成人双胞胎研究：基因和环境（N=13035）队列的一部分。通过瑞典国家患者和死因登记册的诊断来确定终身自杀企图。应用线性模型来评估饮食障碍类别（ANR、ANBP、ANBN、BN、BED、PD 或无饮食障碍[无 ED]）是否与自杀企图相关，并确定与自杀企图相关的因素。与无 ED 的女性相比，所有类型的饮食障碍女性的终身自杀企图明显更为常见。没有饮食障碍特征或人格变量与自杀企图显著相关。在 ANBP 和 ANBN 组中，有自杀企图的个体中并存的精神疾病发生率高于无自杀企图的个体。有清除行为（ANBN、ANBN、BN 和 PD）的表现自杀风险最高，但在所有饮食障碍中风险都增加了。为了改善预后和降低死亡率，必须对自杀保持警惕，并确定风险最大的人群的指标。
