University of Western Ontario, London, Ontario, Canada.
Florida State University, Tallahassee, Florida, United States.
Eur Eat Disord Rev. 2024 Sep;32(5):952-962. doi: 10.1002/erv.3104. Epub 2024 May 17.
Eating disorders (EDs) are associated with elevated suicide. Low body mass index (BMI) and frequency of purging and binge eating represent severity criteria for EDs and distinguish full-threshold EDs from other specified feeding and eating disorders (OSFED). However, no work has taken a transdiagnostic approach to studying whether severity of these or other features is associated with suicidal ideation (SI) and attempts.
We examined diagnostic status, ED features, and SI and attempts in a large, transdiagnostic, community sample of 257 women with EDs and 45 controls without a current or past ED in the United States using the EDs Examination interview and the Structured Clinical Interview for the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders).
SI and suicide attempts (SA) were elevated in OSFED compared to controls but did not differ between OSFED and full-threshold EDs. Higher BMI predicted increased SI. Number of purging methods, but not frequency, was related to history of SA. Binge episode frequency and size were not significant predictors.
OSFED presents with elevated SI and SA, and ED severity criteria that distinguish OSFED from full-threshold EDs do not predict SI or SA. Suicide risk assessments should be implemented universally across EDs in clinical practice.
饮食失调（EDs）与自杀风险升高有关。低体重指数（BMI）和暴食与催吐的频率代表 EDs 的严重程度标准，将完全符合 EDs 与其他特定的进食和饮食障碍（OSFED）区分开来。然而，目前还没有采用跨诊断方法研究这些或其他特征的严重程度是否与自杀意念（SI）和自杀尝试有关。
我们使用 EDs 检查访谈和 DSM-5 结构化临床访谈（Diagnostic and Statistical Manual of Mental Disorders）在美国的一个大型跨诊断、社区样本中，对 257 名患有 ED 的女性和 45 名没有当前或过去 ED 的对照者进行了诊断状况、ED 特征、SI 和尝试的研究。
OSFED 的 SI 和自杀尝试（SA）比对照组高，但与完全符合 EDs 的 OSFED 之间没有差异。较高的 BMI 预测 SI 增加。催吐方法的数量，而不是频率，与 SA 史有关。暴食发作的频率和大小不是显著的预测因素。
OSFED 表现出较高的 SI 和 SA，将 OSFED 与完全符合 EDs 区分开来的 ED 严重程度标准并不能预测 SI 或 SA。自杀风险评估应该在临床实践中普遍应用于 EDs。
