The association of eating disorder specific and unspecific symptoms with suicidal ideation in patients with anorexia nervosa.

Anorexia nervosa is a serious eating disorder with a high mortality rate, ranking among the most lethal mental health conditions. This is not only due to sequelae of cachexia, but also due to suicidality. The present study employs a network analysis approach to determine whether there are unique associations between suicidal ideation and eating disorder-specific symptoms in anorexia nervosa, or if suicidal ideation is more influenced by other symptoms such as those more loosely related to eating disorders or general internalizing symptoms, as well as biological factors. Additionally, we examined the potentially changing impact of symptoms after intensive treatment.

Methods

The study involved female patients with anorexia nervosa admitted to intensive inpatient treatment. Eating disorder-specific and -related symptoms, depressive, anxiety, obsessive-compulsive symptoms, nutritional data as well as suicidal ideation were assessed at two points: immediately after admission (n = 313) and following partial weight gain (n = 217) and were examined together in a network analysis model.

Results

The nodes that were most strongly related to suicidal ideation at both timepoints were feelings of ineffectiveness, as well as depressive and anxiety symptoms. Eating disorder-specific symptoms were found to be not significantly related to suicidal ideation.

Conclusions

The results indicate that suicidal ideation in anorexia nervosa is primarily related to broader psychological symptoms rather than eating disorder-specific symptoms. The prominence of feelings of ineffectiveness within the network highlights the need for clinical interventions that focus on the enhancement of self-efficacy in anorexia nervosa.