The risk of suicide for women with anorexia nervosa is 57 times greater than for healthy women of the same age and racial group, claim researchers. Debra Franko (Northeastern University's Bouvé College of Health Sciences, Massachusetts) and colleagues enrolled 246 women, of whom 51 had anorexia nervosa, restricting subtype, 85 had anorexia nervosa, binge–purge subtype, and 110 suffered with bulimia nervosa.

The participants were interviewed every six to 12 months using the Eating Disorders Longitudinal Interval Follow-up Evaluation, over an average of 8.6 years. In addition, they reported on depressive symptomatology, suicide attempts since the previous interview, and suicidal intent.

In all, four subjects with anorexia committed suicide, while 58 of the 246 subjects reported at least one suicide attempt. Suicide attempts occurred in 21% of those with anorexia restricting subtype group, 31% with the binge–purge subtype, and 19% of bulimic patients.

Data revealed that greater severity of depression and a history of substance abuse or personality disorder predicted the time to first suicide in anorexic patients. Similarly, among bulimic patients, the risk of suicide attempt was heightened by comorbid depression and anorexic symptoms.

Although diagnosis, duration of illness, and binge frequency did not distinguish suicide attempters from non-attempters, a higher frequency of purging behaviors and a history of psychiatric hospitalization were more common among attempters.

In addition, women who saw themselves as lacking in self-efficacy, who were distrustful of others, and had more difficulty identifying internal states were more likely to have attempted suicide.

'Though patients with bulimia nervosa appear to 'look better' than the anorexic patients, they were just as likely to attempt suicide,' the team notes.

The research was presented at the International Conference on Eating Disorders in Boston, US.

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