Suicide attempts requiring hospitalization in patients with eating disorders: A retrospective cohort study

TY - JOUR

T1 - Suicide attempts requiring hospitalization in patients with eating disorders

T2 - A retrospective cohort study

AU - Cliffe, Charlotte

AU - Shetty, Hitesh

AU - Himmerich, Hubertus

AU - Schmidt, Ulrike

AU - Stewart, Robert

AU - Dutta, Rina

PY - 2020/5/1

Y1 - 2020/5/1

N2 - ObjectiveSuicide attempts requiring hospitalization are known to be common in patients who are diagnosed with eating disorders. Attempting suicide is a major indicator for those at risk of completed suicide. Both the specific eating disorder diagnosis and the influence of psychiatric comorbidities on suicide attempts requiring hospitalization were investigated, with demographic and socioeconomic variables as confounders, over a 10‐year observation period from January 2007 to March 2017.MethodsAnonymized health‐record data from the South London and Maudsley NHS Foundation Trust (SLaM) were retrieved through the Clinical Record Interactive Search (CRIS) data resource; this is linked to national Hospital Episode Statistics (HES) data. These data include all diagnoses for inpatient admissions. Hazard ratios, with 95% confidence intervals (CIs), were calculated from cox regression analyses and the effects of a number of confounders were estimated by performing multivariable analyses.ResultsIn total, 4,895 patients were diagnosed with anorexia nervosa (AN), bulimia nervosa (BN), or eating disorder otherwise not specified (EDNOS). Of these, 331 (6.7%) had attempted suicide requiring hospitalization and 21 (0.04%) completed suicide. The eating disorder category associated with the highest risk of a suicide attempt was AN (HR: 1.43, 95%CI: 1.08–1.89, p = .01). The risk was significantly increased further if the patient had a comorbid diagnosis of personality disorder, depression, bipolar affective disorder, and substance misuse.DiscussionSuicide attempts requiring hospitalization have a high incidence rate among patients with eating disorders, and the risk is significantly increased in AN. Comorbid psychiatric illness and suicidal ideation should be carefully assessed in all eating disorder patients.

AB - ObjectiveSuicide attempts requiring hospitalization are known to be common in patients who are diagnosed with eating disorders. Attempting suicide is a major indicator for those at risk of completed suicide. Both the specific eating disorder diagnosis and the influence of psychiatric comorbidities on suicide attempts requiring hospitalization were investigated, with demographic and socioeconomic variables as confounders, over a 10‐year observation period from January 2007 to March 2017.MethodsAnonymized health‐record data from the South London and Maudsley NHS Foundation Trust (SLaM) were retrieved through the Clinical Record Interactive Search (CRIS) data resource; this is linked to national Hospital Episode Statistics (HES) data. These data include all diagnoses for inpatient admissions. Hazard ratios, with 95% confidence intervals (CIs), were calculated from cox regression analyses and the effects of a number of confounders were estimated by performing multivariable analyses.ResultsIn total, 4,895 patients were diagnosed with anorexia nervosa (AN), bulimia nervosa (BN), or eating disorder otherwise not specified (EDNOS). Of these, 331 (6.7%) had attempted suicide requiring hospitalization and 21 (0.04%) completed suicide. The eating disorder category associated with the highest risk of a suicide attempt was AN (HR: 1.43, 95%CI: 1.08–1.89, p = .01). The risk was significantly increased further if the patient had a comorbid diagnosis of personality disorder, depression, bipolar affective disorder, and substance misuse.DiscussionSuicide attempts requiring hospitalization have a high incidence rate among patients with eating disorders, and the risk is significantly increased in AN. Comorbid psychiatric illness and suicidal ideation should be carefully assessed in all eating disorder patients.

KW - anorexia nervosa

KW - bulimia nervosa

KW - eating disorder

KW - self-harm

KW - suicide

KW - suicide attempt

UR - http://www.scopus.com/inward/record.url?scp=85079410203&partnerID=8YFLogxK

U2 - 10.1002/eat.23240

DO - 10.1002/eat.23240

M3 - Article

C2 - 32043625

AN - SCOPUS:85079410203

SN - 0276-3478

VL - 53

SP - 458

EP - 465

JO - International Journal of Eating Disorders

JF - International Journal of Eating Disorders

IS - 5

ER -