饮食障碍和自杀风险

饮食失调可能是痛苦的疾病，有时会夺走受害者的健康、幸福、社会生活和职业成就。因此，自杀是死亡的主要原因也就不足为奇了饮食障碍的人死亡。

Although medical complications related to malnutrition are the leading cause of death among individuals with anorexia nervosa, suicide is believed to follow closely behind. Suicidal behavior is elevated in patients with神经性厌食,bulimia nervosa，和暴饮暴食症，三种饮食障碍最多研究过。

饮食障碍具有任何精神障碍的死亡率最高。虽然研究表明了不同的结果，但患有饮食障碍的患者可能比同龄同龄人的可能性更高的1.5％至14倍。对厌食症神经症患者的死亡率最高，但对于任何饮食障碍的人都很高。

在近期对饮食障碍死亡率的综合研究中，研究人员发现，自杀是最常见的非自然死因。厌食症神经患者的三分之二的非天然死亡和贪食症患者中的所有人都来自自杀，导致研究人员得出结论，“自杀是一种不仅在[厌食症神经系统中的主要问题但在所有饮食障碍中。“

自杀

自杀是指一个广泛的思想和behaviors. It can range from passive ideation (passive thoughts about not wanting to live anymore) to lethal attempts. There is alsononsuicidal self-injurious behavior这是指自我伤害的行为，例如切割，燃烧，刮擦或伤害皮肤。这些行为较少往往反映了对死亡的真正愿望，并且更常见的是管理情绪困扰的机制，不会在本文中讨论。

自杀率和自杀式念头的饮食率不同：饮食障碍类型：

神经性厌食症

Between 20 and 43 percent of those with anorexia nervosa report current suicidal ideation. One study showed that 23 percent of adults with a lifetime diagnosis of anorexia nervosa reported suicidal ideation—this is in comparison to adults in the general population, who report lifetime suicidal ideation in the range of 5 to 15 percent.

患有厌食症的患者也是试图自杀的同行的两到九倍。一项研究表明，厌食症的患者通过自杀的可能性比对比组在患者中死亡18次。

Bulimia Nervosa

关于自杀和神经性贪食症的研究相对较少。结果表明，神经性贪食症患者对自杀意念和自杀企图的估计与神经性厌食症患者相似或更高，但自杀死亡的风险较低。

Between 15 and 23 percent of those with bulimia nervosa report current suicidal ideation. Lifetime suicidal ideation is between 26 to 38 percent among patients with bulimia nervosa. Female patients with bulimia nervosa are seven times more likely to die by suicide than females in the general population.

Binge-Eating Disorder (BED) and Other Specified Feeding and Eating Disorder (OSFED)

关于床上和床上自杀的研究更少OSFED公司。床患者或osfed患者的当前自杀式思想估计为21％至23％。一项研究表明，患有床的患者比同龄人在不吃疾病的情况下尝试过五倍。一项研究发现，患者患者通过自杀的可能性比性别和年龄匹配的同龄人死亡四倍。

Risk Factors

Although suicidal behavior can occur with any type of eating disorder, research suggests it may be more common among patients with certain presentations. Suicide attempts appear to be more common among patients with anorexia binge-purge subtype compared to the restrictive subtype. Some studies have shown that suicide attempts are correlated with purging behaviors including laxative abuse and self-induced vomiting.

当进食障碍与其他疾病（如饮食失调）同时发生时，自杀企图的风险更高抑郁或药物滥用。One study showed that 80 percent of people with anorexia nervosa who attempted suicide reported their attempt occurred while they were depressed. Suicidality might also be more common among eating disorder patients with a history of儿童期虐待。

Genetic studies have shown that anorexia nervosa and suicidality occur together because of shared genetic factors.

研究表明，尝试自杀的个人两个或更多次以更大的风险为未来的尝试，之前的尝试大约在他们的尝试后大约六个月到两年。

警告标志

Warning signs of suicide may include:

• 行为的改变或新行为的出现，特别是在痛苦的事件或损失之后发生的
• 谈谈想要杀死自己，感到绝望，是一种陷入困境，感觉困难，或无法处理的痛苦
• 诸如增加饮酒或吸毒、寻找结束生命的方法、戒断和社会隔离、改变睡眠、打电话或拜访他人道别、赠送重要物品、攻击性和疲劳等行为
• 抑郁、焦虑、冷漠、羞耻、愤怒、易怒或突然解脱等情绪

评估

由于自杀风险升高，常规自杀风险评估应该成为饮食失调治疗的一部分。两个经验性验证和可获得的自杀措施包括Joiner自杀风险评估（JSRA）和Linehan风险评估和管理方案（LRAMP）。

JSRA基于自杀的人际关系理论，是一种半结构化的访谈，将个体划分为一个风险类别（低、中、重或极端）。LAMP提供了一个结构化的清单，用于评估、管理和记录自杀风险，并指导临床医生提供适当的临床干预。临床医生还应该对饮食失调患者进行自杀家族史筛查。

治疗

精神病院治疗can be considered for the treatment of suicidality in eating disorders because it provides increased security for the patient. Other strategies for the short-term management of crises can include increased monitoring and social support, removal of lethal methods, and the treatment of acute psychiatric symptoms.

当患者表明他或她是自杀时，治疗的重点应该是防止自杀。辩证行为治疗（DBT）是一个经验验证的治疗方法，专门用于自由性和自我危害的患者。它也已成功应用于饮食障碍的治疗。在DBT中，行为根据层次结构定位。自杀行为被认为是治疗的最高优先级。

Getting Help

如果您有关于自杀的想法，那么伸出援手是非常重要的。家人和朋友通常可以通过危机来帮助你。还有许多额外的资源可供您或亲人与之交谈。

如果你担心你身边的人可能有自杀的想法，不要害怕问他们，“你有自杀的想法吗？“研究表明，直接问别人并不会让他们产生想法，也不会增加他们尝试的风险。相比之下，它通常是作为一种移情关怀来体验的。

保护他们的安全，如果可以的话，移除致命物品，与他们接触并倾听他们的声音。分享你对他们的关心，让他们知道你关心他们。帮助他们联系专业帮助或自杀热线。

A Word From Verywell

If you (or a loved one) are in crisis or experiencing any suicidal thoughts, plans, or attempts, it is important to reach out for help. When you feel bad it is common to believe that you will always feel bad. It can be hard to remember that feelings are temporary and that things can get better. You are not the only one who has felt this way. Let others help you through this tough time. Also, remember that eating disorders are treatable.