Suicide in Patients with Eating Disorders

Abstract

In eating disorders, there is an increased mortality in addition to diminished quality of life such as physiological and psychological burden and deteriorated social function. Suicide is one of major causes of death and the suicide rate is 1.24 and 0.30 per 1000 person-years in anorexia nervosa (AN) and bulimia nervosa (BN) respectively. Standardized mortality ratio is 31.0 and 7.5 in AN and BN respectively. Mortality rate is the fifth highest after schizophrenia, major depressive disorder, bipolar disorder and substance dependence among psychiatric disorders. Risk factors for suicide in eating disorder patients have been reported to be purging behaviors, psychiatric comorbidity and eating disorder severity, although suicide risk is still elevated in patients with less severe eating disorders. Considering that the number of nonsuicidal self-injuries is large in relation to suicide in eating disorders, we should pay attention to the possibility that we might be exhausted and underestimate suicidal risk after being exposed to repeated nonsuicidal self-injuries.