رفتار خودکشی در نوجوانان و بزرگسالان مبتلا به بولیمیا

Background Recent evidence suggests increased risk for mortality in bulimia nervosa (BN). However, little is yet known about suicidal behavior in BN. Aims To examine frequency and correlates of suicidal ideation and attempts in adolescents and adults with BN in two population-based samples. Method A total of 10,123 adolescents and 2980 adults in two nationally representative surveys of mental disorder were queried regarding eating disorder symptoms and suicidal ideation and attempts. Results Less than 1 percent (0.9%) of adolescents and 1.0% of adults met the criteria for BN. Suicidal ideation was more common among adolescents with BN (53.0%) compared with those with binge eating disorder (BED) (34.4%), other psychopathology (21.3%) or no psychopathology (3.8%). Similar trends emerged for the association between BN and self-reported suicidal plans or attempts. Among adults, suicidality was more common in BN than in the no psychopathology group, but not significantly different from the anorexia nervosa (AN), BED, or other psychopathology subgroups. Conclusion There is a high risk of suicidal ideation and behavior among those with BN. These results underscore the importance of addressing suicide risk in adolescents and adults with eating disorder symptoms.

Although the risk of suicide and increased mortality has been well-documented among those with anorexia nervosa (AN), the occurrence of suicidal ideation and attempts, as well as completed suicide among people with bulimia nervosa (BN) has been less well recognized [1], [2], [3], [4], [5], [6], [7] and [8]. As in AN, suicidal behavior is more prevalent in BN among those with purging behavior [9], [10] and [11], and with co-occurring psychopathology such as obsessive–compulsive disorder [12], borderline personality disorder [13], bipolar disorder [14], [15], [16] and [17] and major depression [18] and [19]. Other factors that may increase the risk for suicidal behavior in BN are impulsivity and body dissatisfaction, both of which have been strongly associated with BN [20], [21] and [22]. Most previous studies of suicidal behavior in BN have been based on small clinical samples that may be biased because of differential representation of those with suicidal behavior in treatment settings. The high magnitude of comorbidity with mood, anxiety and substance use disorders in BN has also been demonstrated in community samples which may therefore provide a valuable resource to investigate potential links between comorbid conditions and suicidal behavior in BN. In addition, few studies have jointly evaluated the risk of suicidal behavior and its correlates in those with eating disorders across the life span. Identification of the specificity of the association between suicidal behavior with particular subtypes of eating disorders in both youth and adults could provide valuable information for potential preventive interventions. Therefore, the goal of this investigation was to examine suicidal behavior and its correlates in adolescents and adults with BN in two large population-based samples.