Meier Marieke, Jansen Katrin, Vertgewall Hannah, Claes Laurence
Institute of Psychology, University of Muenster, Muenster, Germany.
Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium.
Eur Eat Disord Rev. 2025 May;33(3):511-524. doi: 10.1002/erv.3158. Epub 2024 Nov 30.
Eating disorders (EDs) and non-suicidal self-injury (NSSI) are both phenomena with onset in adolescence. Their co-occurrence is associated with higher symptom severity and an elevated risk of suicide. In this meta-analysis, we examine the lifetime prevalence of NSSI in youth with EDs.
We searched PsycInfo, PubMed and previously published systematic reviews for studies reporting on lifetime NSSI prevalence among children and adolescents (19 years or younger) with an ED (anorexia nervosa, bulimia nervosa, binge eating or other specified feeding and EDs) published until June 2024. A generalized linear mixed model meta-analysis was performed to estimate the pooled prevalence. Meta-regressions and multivariate meta-analyses were conducted to estimate separate prevalence rates based on ED diagnosis and care frame (e.g., inpatient vs. outpatient), respectively.
Fifteen studies comprising 3311 children and adolescents were included. Pooled lifetime NSSI prevalence across all ED diagnoses was 34.2% [CI: 27.5%-41.7%]. Heterogeneity was large (I = 93.8%). Lifetime NSSI prevalence rates were significantly higher for participants with bulimia nervosa (53.6%) and those with anorexia nervosa binge-eating/purging type (51.9%) than for participants with anorexia nervosa restrictive type (15.8%).
The small number of studies and the large heterogeneity limit the conclusiveness of this meta-analysis. Results suggest an even higher prevalence of lifetime NSSI in adolescents with an ED than in adults with an ED. The results support previous findings indicating higher prevalence rates of NSSI for EDs associated with binge eating and purging behaviours than for restrictive EDs.
饮食失调（EDs）和非自杀性自伤（NSSI）均为始于青春期的现象。它们的共同出现与更高的症状严重程度以及自杀风险升高相关。在这项荟萃分析中，我们研究了患有饮食失调的青少年中NSSI的终生患病率。
我们在PsycInfo、PubMed以及先前发表的系统评价中检索了截至2024年6月发表的关于患有饮食失调（神经性厌食症、神经性贪食症、暴饮暴食或其他特定的进食和饮食失调）的儿童和青少年（19岁及以下）中NSSI终生患病率的研究。进行了广义线性混合模型荟萃分析以估计合并患病率。分别进行了元回归和多变量荟萃分析，以根据饮食失调诊断和护理框架（例如住院与门诊）估计单独的患病率。
纳入了15项研究，共3311名儿童和青少年。所有饮食失调诊断的合并NSSI终生患病率为34.2%[置信区间：27.5%-41.7%]。异质性很大（I² = 93.8%）。神经性贪食症参与者（53.6%）和神经性厌食症暴饮暴食/清除型参与者（51.9%）的NSSI终生患病率显著高于神经性厌食症限制型参与者（15.8%）。
研究数量少和异质性大限制了这项荟萃分析的结论性。结果表明，患有饮食失调的青少年中NSSI的终生患病率甚至高于患有饮食失调的成年人。结果支持了先前的研究结果，即与暴饮暴食和清除行为相关的饮食失调的NSSI患病率高于限制性饮食失调。
