• anorexia nervosa;
  • bulimia nervosa;
  • binge eating disorder;
  • suicidal behaviour;
  • self-harm

Preti A, Rocchi MBL, Sisti D, Camboni MV, Miotto P. A comprehensive meta-analysis of the risk of suicide in eating disorders.

Objective:  Past meta-analyses on suicide in eating disorders included few available studies.

Method:  PubMed/Medline search for papers including sample n ≥ 40 and follow-up ≥5 years: 40 studies on anorexia nervosa (AN), 16 studies on bulimia nervosa (BN), and three studies on binge eating disorder (BED) were included.

Results:  Of 16 342 patients with AN, 245 suicides occurred over a mean follow-up of 11.1 years (suicide rate = 0.124 per 100 person-years). Standardized mortality ratio (SMR) was 31.0 (Poisson 95% CI = 21.0–44.0); a clear decrease in suicide risk over time was observed in recent decades. Of 1768 patients with BN, four suicides occurred over a mean follow-up of 7.5 years (suicide rate = 0.030 per 100 person-years): SMR was 7.5 (1.6–11.6). No suicide occurred among 246 patients with BED (mean follow-up = 5.3 years).

Conclusion:  AN and BN share many risk factors for suicide: the factors causing lower suicide rates per person-year in BN compared to AN should be investigated.