Department of Psychology, Florida State University, Tallahassee, Florida, USA.
Eating Recovery Center and Pathlight Mood and Anxiety Center, Denver, Colorado, USA.
Int J Eat Disord. 2022 Oct;55(10):1352-1360. doi: 10.1002/eat.23770. Epub 2022 Jul 6.
Suicidality is known to be elevated among people with an eating disorder. The aim of the current study was to examine whether any of three specific behavioral facets of eating disorders (i.e., purging, binge eating, restricting) would be the strongest predictors of suicidal ideation, controlling for one another, in longitudinal analyses from admission to discharge. We hypothesized that purging, above and beyond restricting or binge eating, would be the most important predictor of suicidal ideation.
In the present study, patients with an eating disorder (N = 936), the majority of whom met criteria for a current DSM-5 diagnosis of Anorexia Nervosa (n = 560), completed the Eating Pathology Symptoms Inventory (EPSI) and the Beck Depression Inventory II-Item 9 suicidal ideation index, at admission and again at discharge. The settings were eating disorder treatment facilities offering inpatient, residential, partial hospitalization program (PHP), and intensive outpatient (IOP) levels of care. We pitted EPSI purging, EPSI restriction, and EPSI binge eating against one another in a regression framework predicting discharge suicidal ideation controlling for suicidal ideation at admission.
EPSI Purging significantly predicted both presence/absence of suicidal ideation (β = .22, t = 2.48, p = .01; OR = 1.25, 95% CI [1.05, 1.49]) and intensity of suicidal ideation (β = .04, t = 2.31, p = .02) at discharge, whereas neither EPSI Restricting nor EPSI Binge Eating did (p > .30).
Study results suggest that purging may have particular relevance in estimating suicide risk in patients with an eating disorder.
已知进食障碍患者的自杀率较高。本研究旨在通过入院至出院的纵向分析，检验三种特定的进食障碍行为特征（即：催吐、暴食、限制）中，是否有任何一种特征在控制了其他特征后，是自杀意念最强的预测指标。我们假设，与暴食或限制相比，催吐是自杀意念最重要的预测指标。
在本研究中，患有进食障碍的患者（N=936），其中大多数符合当前 DSM-5 厌食症的诊断标准（n=560），在入院和出院时完成了进食障碍症状检查表（EPSI）和贝克抑郁量表二项 9 项自杀意念指数。研究地点为提供住院、住院、部分住院计划（PHP）和强化门诊（IOP）护理级别的进食障碍治疗机构。我们在回归框架中相互竞争 EPSI 催吐、EPSI 限制和 EPSI 暴食，以预测出院时的自杀意念，同时控制入院时的自杀意念。
EPSI 催吐显著预测了自杀意念的存在/不存在（β=0.22，t=2.48，p=0.01；OR=1.25，95%CI[1.05，1.49]）和自杀意念的强度（β=0.04，t=2.31，p=0.02），而 EPSI 限制和 EPSI 暴食则没有（p>0.30）。
研究结果表明，在评估进食障碍患者的自杀风险时，催吐可能具有特殊的相关性。
