A team from Northeastern University in Boston found that women with this eating disorder were 57 times more likely to successfully take their own life than healthy counterparts and were also more likely to attempt suicide.

Greater severity of depression and history of substance abuse or personality disorder predicted the time to first suicide attempt for the anorexic patients studied.

Dr Debra Franko and colleagues interviewed 246 women with eating disorders about eating disorder symptomatology, comorbid psychopathology, treatment and psychosocial functioning every 6 to 12 months for an average of 8.6 years.

The study sample comprised 51 women with the restricting subtype of anorexia nervosa, 85 with the binge-purge subtype and 110 with bulimia nervosa.

Subjects reporting depressive symptomatology were asked about suicide attempts. For each suicidal attempt reported, intent and medical threat were ascertained.

During the course of the investigation four subjects died by suicide and 58 subjects reported at least one suicide attempt. More than half of those who reported a suicide attempt had made multiple attempts at suicide.

Those who attempted suicide reported higher frequency of purging and were more likely to have had a previous hospitalisation for a psychiatric condition. Poor psychosocial functioning, personality disorder and substance abuse were also linked to suicide risk, while individual and group therapy appeared to have a protective effect.

Type of eating disorder, duration of illness and binge frequency did not appear to influence suicide risk.

“Women who saw themselves as lacking in self-efficacy, were distrustful of others and had more difficulty in identifying internal states were more likely to have a suicide attempt,” said the study authors.

They said that women who have worse psychosocial functioning might be at greater risk of suicide attempts and that clinicians should, therefore, closely monitor patients’ employment, family and social relationships and leisure activities, particularly when depression is present.

Source: International Conference on Eating Disorders, Boston, US, April 25-28, 2002

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