Prevalence of suicide attempt, suicide ideation and self-harm at diagnosis in adolescents with eating disorders

Int J Psychiatry Clin Pract. 2024 Mar;28(1):63-67. doi: 10.1080/13651501.2024.2337796. Epub 2024 Apr 9.

Abstract

Background: Data concerning the suicide prevalence of eating disorder (ED) subtypes and predictive factors are lacking in youth. This study aimed to examine suicide attempts (SA), suicide ideation (SI) and self-harm (SH) upon diagnosis in adolescents with EDs.

Methods: The prevalence of SA, SI and SH in ED subtypes was evaluated by retrospectively assessing the Home, Education/Employment, Eating, Activities, Drugs, Sexuality, Suicidal ideation and Safety (HEEADSSS) instrument of adolescents diagnosed with an ED. Clinical predictors of SI in anorexia nervosa (AN) and atypical AN (AAN) were assessed.

Results: Among all participants (398), 41 (10.3%) reported SA, 126 (31.7%) SI and 60 (15.1%) SH. While SA did not differ statistically between ED subgroups (p = .123), they were two times more prevalent in the bulimia nervosa (BN) group (17.5%) than in the AN group (8.5%). In the BN group, SI was 2.3 times more prevalent than in the AN group (p = .001). The AN and ARFID groups exhibited substantially less SH (p = .036). Having a higher body mass index (BMI) was the only significant predictor of SI.

Conclusions: This study demonstrates that adolescents with EDs are at an increased risk for suicidality, highlighting the need for close screening, particularly in those with BN, AN-BP and AN with a higher BMI.

Keywords: Eating disorder; adolescent; self-harm; suicide attempt; suicide ideation.

Plain language summary

Adolescents with eating disorders have higher rates of suicidality than the general population.Bulimia nervosa had the highest risk for a suicide attempt, suicide ideation and self-harm at diagnosis.A higher body mass index (BMI) percentage was associated with an increased risk of suicidality in the anorexia nervosa group.

MeSH terms

  • Adolescent
  • Anorexia Nervosa* / epidemiology
  • Bulimia Nervosa / epidemiology
  • Feeding and Eating Disorders* / diagnosis
  • Feeding and Eating Disorders* / epidemiology
  • Female
  • Humans
  • Male
  • Prevalence
  • Retrospective Studies
  • Self-Injurious Behavior* / epidemiology
  • Suicidal Ideation*
  • Suicide, Attempted* / statistics & numerical data