Suicide attempts in bulimia nervosa: personality and psychopathological correlates

Laura Forcano, Fernando Fernández-Aranda, Eva Alvarez-Moya, Cynthia Bulik, Roser Granero, Mònica Gratacòs, Susana Jiménez-Murcia, Isabel Krug, Josep M Mercader, Nadine Riesco, Ester Saus, Juan José Santamaría, Xavier Estivill
European Psychiatry: the Journal of the Association of European Psychiatrists 2009, 24 (2): 91-7

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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