Suicide attempts in bulimia nervosa: Personality and psychopathological correlates - 19/12/08

Doi : 10.1016/j.eurpsy.2008.10.002

Laura Forcano ^a,^b, Fernando Fernández-Aranda ^a,^b,^⁎ , Eva Álvarez-Moya ^a,^b, Cynthia Bulik ^c, Roser Granero ^d, Mònica Gratacòs ^e,^f, Susana Jiménez-Murcia ^a,^b, Isabel Krug ^a,^b, Josep M. Mercader ^b, Nadine Riesco ^a, Ester Saus ^e,^f, Juan José Santamaría ^a, Xavier Estivill ^e,^f,^g
^a Department of Psychiatry, University Hospital of Bellvitge, c/Feixa Llarga s/n, 08907 Barcelona, Spain
^b Ciber Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Spain
^c Department of Psychiatry, University of North Carolina at Chapel Hill, Campus Box #7160, Chapel Hill, NC 27599-7160, USA
^d Laboratori d'Estadística Aplicada, Departament de Psicobiologia i Metodologia, Universitat Autònoma de Barcelona, Spain
^e Genetic Causes of Disease Group, Genes and Disease Program Center for Genomic Regulation (CRG-UPF), Dr. Aiguader, 88, 08003 Barcelona, Spain
^f CIBER en Epidemiología y Salud Pública (CIBERESP), Parc de Recerca Biomèdica de Barcelona, Doctor Aiguader, 88 1^a Planta, 08003 Barcelona, Spain
^g Department of Health and Experimental Life Sciences, Pompeu Fabra University (UPF), c/ Dr. Aiguader, 88, 08003 Barcelona, Catalonia, Spain

Corresponding author. Department of Psychiatry, University Hospital of Bellvitge, c/Feixa Llarga s/n, 08907 Barcelona, Spain. Tel.: +34 93 2607922; fax: +34 93 2607658.

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Friday 19 December 2008
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Abstract

Background

Little evidence exists about suicidal acts in eating disorders and its relation with personality. We explored the prevalence of lifetime suicide attempts (SA) in women with bulimia nervosa (BN), and compared eating disorder symptoms, general psychopathology, impulsivity and personality between individuals who had and had not attempted suicide. We also determined the variables that better correlate with of SA.

Method

Five hundred sixty-six BN outpatients (417 BN purging, 47 BN non-purging and 102 subthreshold BN) participated in the study.

Results

Lifetime prevalence of suicide attempts was 26.9%. BN subtype was not associated with lifetime SA (p=0.36). Suicide attempters exhibited higher rates on eating symptomatology, general psychopathology, impulsive behaviors, more frequent history of childhood obesity and parental alcohol abuse (p<0.004). Suicide attempters exhibited higher scores on harm avoidance and lower on self-directedness, reward dependence and cooperativeness (p<0.002). The most strongly correlated variables with SA were: lower education, minimum BMI, previous eating disorder treatment, low self-directedness, and familial history of alcohol abuse (p<0.006).

Conclusion

Our results support the notion that internalizing personality traits combined with impulsivity may increase the probability of suicidal behaviors in these patients. Future research may increase our understanding of the role of suicidality to work towards rational prevention of suicidal attempts.

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Keywords : Eating disorders, Suicidal behavior, Predictors, Psychopathology, Eating disorder not otherwise specified, Suicide, Psychiatry in Europe, Psychometry and assessments in psychiatry