Comorbid psychopathology, including self-harm and suicidal behavior, is often found in patients with eating disorders. To better understand the reasons for high comorbid psychopathology among eating disorders, self-harm, and suicidal behavior, we examined this comorbidity in female patients hospitalized with eating disorders. In a sample of 47 girls admitted for anorexia nervosa, atypical anorexia nervosa, and bulimia nervosa, 72% had depressive symptoms, 11% had obsessive-compulsive symptoms, 9% had anxiety disorder, 23% had substance abuse, and 57% had disharmonious personality development. Suicidal behavior was present in 60% of patients and self-harm in 49%. Association was found between self-harm and suicidality. In all, 68% of girls with eating disorders had a positive score in the Children's Depression Inventory questionnaire and 62% of them in the Child Adolescent Suicidal Potential Index questionnaire. Clinical examination of girls with eating disorders should focus on identifying the risk of suicidal behavior and self-harm.

Department of Child Psychiatry Charles University 2nd Faculty of Medicine University Hospital Motol Prague Czech Republic

Zobrazit více v PubMed

Bulik CM, Thornton L, Pinheiro AP, et al. Suicide attempts in anorexia nervosa. Psychosom Med. 2008;70(3):378–383. PubMed

Favaro A, Santonastaso P. Suicidality in eating disorders: clinical and psychological correlates. Acta Psychiatr Scandinavica. 1997;95(6):508–514. PubMed

Favaro A, Santonastaso P. Self-injurious behavior in anorexia nervosa. J Nerv Menl Dis. 2000;188(8):537–542. PubMed

Fennig S, Hadas A. Suicidal behaviour and depression in adolescents with eating disorders. Nord J Psychiatry. 2010;64(1):32–39. PubMed

Franko DL, Keel PK. Suicidality in eating disorders: occurrence, correlates, and clinical implications. Clin Psychol Rev. 2006;26(6):769–782. PubMed

Mayes SD, Fernandez-Mendoza J, Baweja R, et al. Correlates of suicide ideation and attempts in children and adolescents with eating disorders. Eat Disord. 2014;22(4):352–366. PubMed

Pompilli M, Girardi P, Tatarelli G, Ruberto A, Tatarelli R. Suicide and attempted suicide in eating disorders, obesity and weight-image concern. Eat Behav. 2006;7(4):384–394. PubMed

Suokas JT, Suvisaari JM, Grainger M, Raevuori A, Gissler M, Haukka J. Suicide attempts and mortality in eating disorders: a follow-up study of eating disorder patients. Gen Hosp Psychiatry. 2014;36(3):355–357. PubMed

Johnson JG, Cohen P, Kasen S, Brook JS. Eating disorders during adolescence and the risk for physical and mental disorders during early adulthood. Arch Gen Psychiatry. 2002;59:545–552. PubMed

Skegg K. Self-harm. Lancet. 2005;366:1471–1483. PubMed

Jacobson CM, Gould M. The epidemiology and phenomenology of non-suicidal self-injurious behavior among adolescents: a critical review of the literature. Arch Suicide Res. 2007;11(2):129–147. PubMed

Claes L, Vandereycken W, Vertommen H. Self-care versus self-harm: piercing, tattooing, and self-injuring in eating disorders. Eur Eat Disord Rev. 2005;13:11–18.

Krásničanová H, Veselá M, Vejvalka J, Koutek J. Selected auxiological aspects of anorexia nervosa-relations of body weight to body height and menstrual cycle. Neuroendocrinol Lett. 2007;28(4):527–534. PubMed

Davison KM, Marshall-Fabien GL, Gondara L. Sex differences and eating disorder risk among psychiatric conditions, compulsive behaviors and substance use in a screened Canadian national sample. Gen Hosp Psychiat. 2014;36(4):411–414. PubMed

Pfeffer CR, Jiang H, Kakuma T. Child-Adolescent Suicidal Potential Index (CASPI): a screen for risk for early onset suicidal behaviour. Psychol Assess. 2000;12:304–318. PubMed

Kovacs M. The Children’s Depression Inventory. North Tonawanda, NY: Multi-Health Systems; 1992.

Papežová H. Spektrum poruch příjmu potravy [Eating disorders spectrum] Praha: Grada; 2010. Czech.

Krch F. Poruchy příjmu potravy [Eating disorders] Praha: Grada; 2005. Czech.

Papežová H, Kocourková J, Koutek J. Poruchy příjmu potravy. In: Raboch J, et al., editors. Doporučené postupy psychiatrické péče IV [The clinical practice guidelines for psychiatric care] Praha: Psychiatrická společnost ČLS JEP; 2014. Czech.

Nelson G, Hanna R, Houri A, Klimes-Dougan B. Protective functions of religious traditions for suicide risk. Suicidol Online. 2012;3:59–71.

Chylová M, Pálová E, Kovaničková M. Breznoščáková. Prieskum suicidálnoho správania v období dospievania [Survey of suicidal behavior in adolescence] Cesk Psychol. 2011;55(4):306–315. Czech.

Wilkinson PO. Nonsuicidal self-injury: a clear marker for suicide risk. J Am Acad Child Adolesc Psychiatry. 2011;50(8):741–743. PubMed

Brent DA. Preventing youth suicide: time to ask how. J Am Acad Child Adolesc Psychiatry. 2011;50(8):738–740. PubMed

Koutek J, Kocourková J, Hladíková M, Hrdlička M. Suicidal behaviour in children and adolescents: does a history of trauma predict less severe suicidal attempts? Neuroendocrinol Lett. 2009;30(1):99–106. PubMed