The primary aim of this study was to evaluate whether the prevalence of lifetime suicide attempts/completions (SACs) is greater in women with anorexia nervosa (AN) and women bulimia nervosa (BN) than women with no eating disorder (no ED). Additional aims included identifying eating disorder features, comorbid psychopathology, and temperament features associated with SACs separately in the women with AN and with BN. Women in the Swedish Twin study of Adults: Gene and Environment (STAGE; n = 12,981) and the Screening Across the Lifespan of Twins (SALT; n = 16,281) cohorts completed questionnaires assessing eating disorder behaviors, lifetime history of psychiatric disorders, and temperament. Lifetime SACs were identified using diagnoses from the Swedish National Patient Register and the Cause of Death Register. STAGE and SALT were analyzed separately. General linear models were used to evaluate whether ED category (AN, BN, or no ED) was associated with SACs, and to identify factors associated with SACs. The prevalence of SAC was higher for women in both the AN or BN categories compared with women with no ED in both STAGE and SALT. In STAGE, depression and panic disorder were associated with SACs in women with AN, and vomiting, depression, substance use and panic disorder were associated with SACs in women with BN. In SALT, alcohol abuse/dependence was associated with SACs in women with AN; no factors were identified as associated with SACs in women with BN. All identified factors acted in an additive manner and did not interact with eating disorder status to differentially increase risk. Results of this investigation may assist with identification of individuals with eating disorders at highest risk for SAC and directly inform treatment and prevention efforts.Doctor of Philosoph
