Clinical profile of patients with eating disorders attending emergency services after suicide attempt

Suicidal behaviour is a major public health issue, particularly among individuals with eating disorders (EDs), who exhibit elevated risks of suicidal ideation and attempts. EDs, including anorexia nervosa and bulimia nervosa, are associated with significant psychological distress and psychiatric comorbidities, contributing to higher suicide rates.

This study aimed to explore the clinical characteristics and suicidal behaviour in patients with EDs following a suicide attempt. Specifically, we sought to analyse the influence of sociodemographic factors, psychiatric comorbidities, impulsivity, and childhood trauma on suicide-related outcomes.

A total of 1441 adults were included, of whom 131 (9.1%) had an ED diagnosis. Participants were categorized into ED and no-ED groups. Group comparisons were conducted using χ² and ANOVA tests. Linear and logistic regression models explored the influence of sociodemographic and clinical variables (e.g., comorbidities, impulsivity, trauma) on suicidal ideation intensity, number of suicide behaviours, and medical damage from the index attempt.

The ED group was younger, predominantly female, and had higher educational attainment. Clinically, they showed greater psychopathology, higher rates of non-suicidal self-injury (NSSI), emotional and sexual abuse, and more previous suicide attempts. They also exhibited a higher number of suicidal behaviours (d=0.70), but only slightly greater ideation intensity (d=0.28). Regression models identified psychiatric comorbidities, depression, acquired capability, and past attempts as key predictors of ideation; suicide behaviours were associated with ED (binging-purging subtype), comorbidities, psychotic symptoms, NSSI, and prior attempts.

EDs, particularly those with binging-purging patterns, are linked to repeated suicidal behaviour. Suicide risk assessments in ED patients should consider comorbidities, trauma, NSSI, and impulsivity to guide targeted interventions.