BOSTON, Mass. - In a study of suicidal behavior of 246 women with eating disorders over a span of 8.6 years, Debra L. Franko, an associate professor of counseling psychology at Northeastern University's Bouvé College of Health Sciences, and her colleagues at Massachusetts General Hospital (MGH), found that women with anorexia nervosa are 57 times more likely to commit suicide than the expected rate for other women in the same age and racial groups. Eating disorder patients who are more psychiatrically ill were found to be at a greater risk to attempt suicide. Franko's research was chosen by the Academy for Eating Disorders to be presented at the International Conference on Eating Disorders, happening April 25-28 in Boston.
In the 246 women studied at MGH, 51 women had anorexia nervosa restricting subtype (ANR), 85 women had anorexia nervosa, binge-purge subtype (ANBP), and 110 women had bulimia nervosa (BN). Four subjects (who were all diagnosed with anorexia nervosa at the start of the study) died by suicide, resulting in an elevated standardized mortality ratio of 56.9 for the anorexia nervosa subgroup. A total of 58 of the 246 subjects reported at least one suicide attempt during the course of the study, and of these, 32 made multiple attempts. Suicide attempts occurred in 21% of the ANR subjects, 31% of those with ANBP, and 19% of the BN sufferers.
Data indicated that greater severity of depression and history of substance abuse or personality disorder predicted the time to first suicide attempt for anorexic subjects.
For bulimic subjects, the severity of anorexic behavior as well as depression predicted the likelihood of their suicide attempt. "Though patients with bulimia nervosa appeared to "look better," than the anorexic patients, they were just as likely to attempt suicide, especially those who suffered from depression and had anorexic symptoms," said Franko.
Interestingly, regardless of subgroup, women who were distrustful of others, lacked self-esteem and had more difficulty identifying internal states were more likely to have made a suicide attempt.
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