Eating disorders and suicidality: what we know, what we don't know, and suggestions for future research

Current Opinion in Psychology

Volumn 22, Issue , 2018, Pages 63-67

  Smith, April R ^a   Zuromski, Kelly L ^b   Dodd, Dorian R ^a  

^a MIAMI UNIVERSITY   (United States)

^b AUBURN UNIVERSITY   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

EATING DISORDER; HUMAN; MORTALITY; PSYCHOLOGY; SUICIDE;

FEEDING AND EATING DISORDERS; HUMANS; SUICIDE;

EID: 85028313341     PISSN: 2352250X     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.copsyc.2017.08.023     Document Type: Review

References (51)

1. American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders. 5th ed., 2013, American Psychiatric Association.
2. Hudson, J.I., Hiripi, E., Pope, H.G., Kessler, R.C., The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biol Psychiatry 61 (2007), 348–358.
3. Smink, F.R., Van Hoeken, D., Hoek, H.W., Epidemiology of eating disorders: incidence, prevalence and mortality rates. Curr Psychiatry Rep 14 (2012), 406–414.
4. Bulik, C.M., Thornton, L., Pinheiro, A.P., Plotnicov, K., Klump, K.L., Brandt, H., Crawford, S., Manfred, M.F., Halmi, K.A., Johnson, C., et al. Suicide attempts in anorexia nervosa. Psychosom Med 70 (2008), 378–383.
5. Franko, D.L., Keel, P.K., Dorer, D.J., Blais, M.A., Delinsky, S.S., Eddy, K.T., Charat, V., Renn, R., Herzog, D.B., What predicts suicide attempts in women with eating disorders?. Psychol Med 34 (2004), 843–853.
6. Eddy, K.T., Dorer, D.J., Franko, D.L., Tahilani, K., Thompson-Brenner, H., Herzog, D.B., Diagnostic crossover in anorexia nervosa and bulimia nervosa: implications for DSM-V. Am J Psychiatry 165 (2008), 245–250.
7. Franko, D.L., Keshaviah, A., Eddy, K.T., Krishna, M., Davis, M.C., Keel, P.K., Herzog, D.B., A longitudinal investigation of mortality in anorexia nervosa and bulimia nervosa. Am J Psychiatry 170 (2013), 917–925.
8. Arcelus, J., Mitchell, A.J., Wales, J., Nielsen, S., Mortality rates in patients with anorexia nervosa and other eating disorders. Arch Gen Psychiatry 68 (2011), 724–731.
9. Sullivan, P.F., Mortality in anorexia nervosa. Am J Psychiatry 152 (2011), 1073–1074.
10. Crow, S., Peterson, C., Swanson, S., Raymond, N., Specker, S., Eckert, E., Mitchell, J., Increased mortality in bulimia nervosa and other eating disorders. Am J Psychiatry 166 (2009), 1342–1346.
11. Forrest, L.N., Zuromski, K.L., Dodd, D.R., Smith, A.R., Suicidality in adults and adolescents with binge eating disorder: results from the national comorbidity survey replication and adolescent supplement. Int J Eat Disord 50 (2017), 40–49 Using a large, nationally representative adolescent and adult sample, the authors investigated relationships between binge eating disorder and suicidality. The authors found binge eating disorder was associated with elevated odds of suicide ideation, planning, and attempt; however, this relationship weakened when controlling for comorbid conditions. Additionally, suicidality tended to occur prior to binge eating disorder onset among adults, but after binge eating disorder onset among adolescents.
12. Smith, A.R., Witte, T.K., Crow, S., Eating disorders and suicide. Nemeroff, C., Koslow, S., Ruiz, P., (eds.) A Concise Guide to Understanding Suicide: Epidemiology, Pathophysiology, and Prevention, 2013, Cambridge University Press, 123–129.
13. American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders. edn 4, text rev., 2000, American Psychiatric Association.
14. Favaro, A., Santonastaso, P., Suicidality in eating disorders: clinical and psychological correlates. Acta Psychiatr Scand 95 (1997), 508–514.
15. Milos, G., Spindler, A., Hepp, U., Schnyder, U., Suicide attempts and suicidal ideation: links with psychiatric comorbidity in eating disorder subjects. Gen Hosp Psychiatry 26 (2004), 129–135.
16. Nock, M.K., Borges, G., Bromet, E.J., Cha, C.B., Kessler, R.C., Lee, S., Suicide and suicidal behavior. Epidemiol Rev 30 (2008), 133–154.
17. Valtonen, H., Suominen, K., Mantere, O., Leppämäki, S., Arvilommi, P., Isometsä, E.T., Suicidal ideation and attempts in bipolar I and II disorders. J Clin Psychiatry 66 (2005), 1456–1462.
18. Fenton, W.S., McGlashan, T.H., Victor, B.J., Blyler, C.R., Symptoms, subtype, and suicidality in patients with schizophrenia spectrum disorders. Am J Psychiatry 154 (1997), 199–204.
19. Crow, S.J., Swanson, S.A., le Grange, D., Feig, E.H., Merikangas, K.R., Suicidal behavior in adolescents and adults with bulimia nervosa. Compr Psychiatry 55 (2014), 1534–1539.
20. Forcano, L., Álvarez, E., Santamaría, J.J., Jimenez-Murcia, S., Granero, R., Penelo, E., Alonso, P., Sanchez, I., Menchon, J.M., Ulman, F., et al. Suicide attempts in anorexia nervosa subtypes. Compr Psychiatry 52 (2011), 352–358.
21. Tarrier, N., Barrowclough, C., Andrews, B., Gregg, L., Risk of non-fatal suicide ideation and behaviour in recent onset schizophrenia. Soc Psychiatry Psychiatr Epidemiol 39 (2004), 927–937.
22. Pisetsky, E.M., Thornton, L.M., Lichtenstein, P., Pedersen, N.L., Bulik, C.M., Suicide attempts in women with eating disorders. J Abnorm Psychol 122 (2013), 1042–1056.
23. Guillaume, S., Jaussent, I., Olie, E., Genty, C., Bringer, J., Courtet, P., Schmidt, U., Characteristics of suicide attempts in anorexia and bulimia nervosa: a case–control study. PLoS ONE, 6, 2011, e23578, 10.1371/journal.pone.0023578.
24. Preti, A., Rocchi, M.B.L., Sisti, D., Camboni, M.V., Miotto, P., A comprehensive meta-analysis of the risk of suicide in eating disorders. Acta Psychiatr Scand 124 (2011), 6–17.
25. Keshaviah, A., Edkins, K., Hastings, E.R., Krishna, M., Franko, D.L., Herzog, D.B., Thomas, J.J., Murray, H.B., Eddy, K.T., Re-examining premature mortality in anorexia nervosa: a meta-analysis redux. Compr Psychiatry 55 (2014), 1773–1784 The authors conducted a meta-analysis of 40 studies published between 1966 and 2010 in order to calculate all-cause and suicide-specific standardized mortality ratios (SMRs). The authors’ SMR estimates were lower than previous studies; participants with anorexia nervosa were found to be 5.2 times more likely to die prematurely from any cause and 18.1 times more likely to die by suicide than gender and aged matched samples.
26. Chesney, E., Goodwin, G.M., Fazel, S., Risks of all-cause and suicide mortality in mental disorders: a meta review. World Psychiatry 13 (2014), 153–160.
27. Franko, D.L., Keel, P.K., Suicidality in eating disorders: occurrence, correlates, and clinical implications. Clin Psychol Rev 26 (2006), 769–782.
28. Corcos, M., Taieb, O., Benoit-Lamy, S., Paterniti, S., Jeammet, P., Flament, M.F., Suicide attempts in women with bulimia nervosa: frequency and characteristics. Acta Psychiatr Scand 106 (2002), 381–386.
29. Carano, A., De Berardis, D., Campanella, D., Serroni, N., Ferri, F., Di Iorio, G., Acciavatti, T., Mancini, L., Mariani, G., Martinotti, G., et al. Alexithymia and suicide ideation in a sample of patients with binge eating disorder. J Psychiatr Pract 18 (2012), 5–11.
30. Coren, S., Hewitt, P.L., Is anorexia nervosa associated with elevated rates of suicide?. Am J Public Health 88 (1998), 1206–1207.
31. Nock, M.K., Hwang, I., Sampson, N., Kessler, R.C., Angermeyer, M., Beautrais, A., Borges, G., Bromet, E., Bruffaerts, R., de Girolamo, G., et al. Cross-national analysis of the associations among mental disorders and suicidal behavior: findings from the WHO World Mental Health Surveys. PLoS Med, 6, 2009, e1000123, 10.1371/journal.pmed.1000123.
32. Bodell, L.P., Joiner, T.E., Keel, P.K., Comorbidity-independent risk for suicidality increases with bulimia nervosa but not with anorexia nervosa. J Psychiatr Res 47 (2013), 617–621.
33. Yao, S., Kuja-Halkola, R., Thornton, L.M., Runfola, C.D., D'Onofrio, B.M., Almqvist, C., Lichtenstein, P., Sjolander, A., Larsson, H., Bulik, C.M., Familial liability for eating disorders and suicide attempts: evidence from a population registry in Sweden. JAMA Psychiatry 73 (2016), 284–291 This study reports on a large Swedish registry; the authors were interested in estimating whether there was a shared familial risk for both eating disorders and suicide. Results revealed that significant associations between eating disorders and suicide were not fully explained by comorbid conditions; further, they found evidence that the association between eating disorders and suicide is partly influenced by familial risk factors that appear to be genetic in origin.
34. Thornton, L.M., Welch, E., Munn-Chernoff, M.A., Lichtenstein, P., Bulik, C.M., Anorexia nervosa, major depression, and suicide attempts: shared genetic factors. Suicide Life-Threat Behav 46 (2016), 525–534.
35. Wade, T.D., Fairweather-Schmidt, A.K., Zhu, G., Martin, N.G., Does shared genetic risk contribute to the co-occurrence of eating disorders and suicidality?. Int J Eat Disord 48 (2015), 684–691 Using an Australian twin registry (N = 1002) the authors examined whether suicidality and eating disorders have a common genetic pathway. Results suggested that shared genetic risk factors account for the co-occurrence of eating disorders and suicidality; these results held even when controlling for major depression diagnosis.
36. Joiner, T., Why People Die by Suicide. 2005, Harvard University Press.
37. Van Orden, K.A., Witte, T.K., Cukrowicz, K.C., Braithwaite, S.R., Selby, E.A., Joiner, T.E. Jr., The interpersonal theory of suicide. Psychol Rev 117 (2010), 575–600.
38. Smith, A.R., Fink, E.L., Anestis, M.D., Ribeiro, J., Gordon, K.H., Davis, H., Keel, P.K., Bardone-Cone, A.M., Peterson, C.B., Klein, M.H., et al. Exercise caution: over-exercise is associated with suicidality in bulimia nervosa. Psychiatry Res 26 (2013), 246–255.
39. Witte, T.K., Zuromski, K.L., Gauthier, J.M., Smith, A.R., Bartlett, M., Siegfried, N., Bodell, L., Goodwin, N., Restrictive eating: associated with suicide attempts, but not acquired capability in residential patients with eating disorders. Psychiatry Res 235 (2016), 90–96 In a sample of 100 eating disorder patients, the authors tested whether the capability for suicide (pain tolerance and fearlessness about death) would account for the relationship between anorexia nervosa and suicide attempts. Although restriction was associated with past suicide attempts, anorexia diagnosis was not associated with either past suicide attempts or capability for suicide.
40. Zuromski, K.L., Witte, T.K., Fasting and acquired capability for suicide: a test of the interpersonal-psychological theory of suicide in an undergraduate sample. Psychiatry Res 226 (2015), 61–67.
41. Smith, A.R., Dodd, D.R., Forrest, L.N., Witte, T.W., Bodell, L., Ribeiro, J.D., Goodwin, N., Siegfried, N., Bartlett, M., Does the Interpersonal–Psychological Theory of Suicide (IPTS) provide a useful framework for understanding suicide risk among eating disorder patients? A test of the validity of the IPTS. Int J Eat Disord 49 (2016), 1082–1086 The authors tested key tenants of the interpersonal theory of suicide in a sample of 100 eating disorder patients. They found that perceived burdensomeness was associated with suicidal ideation, and perceived burdensomeness and fearlessness about death were associated with past suicide attempts; however, the eating disorder groups did not have greater fearlessness about death relative to a control group or a psychiatric comparison group.
42. Dodd, D.R., Smith, A.R., Bodell, L.P., Restraint feeds stress: the relationship between eating disorder symptoms, stress generation, and the interpersonal theory of suicide. Eat Behav 15 (2014), 567–573.
43. Forrest, L.N., Bodell, L.P., Witte, T.K., Goodwin, N., Bartlett, M.L., Siegfried, N., Eddy, K.T., Thomas, J.J., Franko, D.L., Smith, A.R., Associations between eating disorder symptoms and suicidal ideation through thwarted belongingness and perceived burdensomeness among eating disorder patients. J Affect Disord 195 (2016), 127–135.
44. Freuchen, A., Kjelsberg, E., Lundervold, A.J., Groholt, B., Differences between children and adolescents who commit suicide and their peers: a psychological autopsy of suicide victims compared to accident victims and a community sample. Child Adolesc Psychiatry Ment Health, 6, 2012, 1.
45. Vijayakumar, L., Rajkumar, S., Are risk factors for suicide universal? A case–control study in India. Acta Psychiatr Scand 99 (1999), 407–411.
46. Yang, G.H., Phillips, M.R., Zhou, M., Wang, L., Zhang, Y., Xu, D., Understanding the unique characteristics of suicide in China: National Psychological Autopsy Study. Biomed Environ Sci 18 (2005), 379–389.
47. Bostwick, J.M., Pankratz, V.S., Affective disorders and suicide risk: a reexamination. Am J Psychiatry 157 (2000), 1925–1932.
48. Kraemer, H.C., Kazdin, A.E., Offord, D.R., Kessler, R.C., Jensen, P.S., Kupfer, D.J., Coming to terms with the terms of risk. Arch Gen Psychiatry 54 (1997), 337–343.
49. Franklin, J.C., Ribeiro, J.D., Fox, K.R., Bentley, K.H., Kleiman, E.M., Huang, X., Musacchio, K.M., Jaroszewski, A.C., Chang, B.P., Nock, M.K., Risk factors for suicidal thoughts and behaviors: a meta-analysis of 50 years of research. Psychol Bull 143 (2017), 187–232.
50. Smith AR et al., unpublished: Are eating disorders and related symptoms risk factors for suicidal thoughts and behaviors? A meta-analysis.
51. Anderson, L., Smith, A.R., Crow, S., Suicidality, self-injurious behavior, and eating disorders. Anderson, L., Murray, S., Kaye, W., (eds.) Handbook of Complex and Atypical Eating Disorders, 2017, Oxford University Press, 2017.