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 ≥5years: 40 studies on anorexia nervosa (AN), 16 studies on bulimia nervosa (BN), and three studies on binge eating disorder (BED) were included. Results: Of 16342 patients with AN, 245 suicides occurred over a mean follow-upof 11.1years (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-upof 7.5years (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=5.3years). 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.