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Suicidal ideas and behaviours by anyone with anorexia nervosa "should not be overlooked as something that will just pass," Bulik said. Suicidal gestures "should be considered very seriously, and dealt with appropriately by a professional," she told Reuters Health.

Bulik, director of the eating disorders program at the University of North Carolina at Chapel Hill, and colleagues looked at patterns of attempted suicide among people with anorexia nervosa who enrolled in the Genetics of Anorexia Nervosa Collaborative Study.

The 413 study participants, nearly all female, ranged in age from 16 to 76 years. Almost 17 percent of the group reported at least one suicide attempt, initially occurring between 7 and 40 years of age. More than half of these cases required medical attention, the investigators report in the medical journal Psychosomatic Medicine.

Linked to other psychological disorders
Those with the restricting subtype of anorexia nervosa, defined as severe restriction of food intake, but no lifetime history of binge eating or purging, appear to have the lowest risk, as the researchers found just over 7 percent of this group reported at least one suicide attempt.

By contrast, 26, 29, and 21 percent of participants with the purging, binging, and combined anorexia/bulimia subtypes reported at least one suicide attempt, the researchers note. These subtypes involve single or combined behaviours such as vomiting, laxative or diuretic abuse, and binge eating.

Besides the known association between depression and suicide risk, Bulik's group found suicide attempts were linked with additional factors such as panic disorder, post-traumatic stress disorder, substance abuse or dependence, dramatic or erratic behaviour, impulse-control disturbances, and self-harm or stealing behaviours.

"This study underscores again that anorexia nervosa is a serious mental illness," Bulik concluded. – (Joene Hendry/Reuters Health)

SOURCE: Psychosomatic Medicine, April 2008.

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