Abstract
BackgroundAlthough there is much literature on adolescent suicide, combined effects of depression and anorexia nervosa on suicide were rarely investigated. The aims of this study are to examine the association between anorexia nervosa and suicidal thoughts and explore the interaction between anorexia nervosa and depression.MethodsThis is a cross-sectional study, in the study, a sample of 8,746 Chinese adolescents was selected by multistage stratified method in 2012/2013 from 20 middle schools in 7 provinces across China Mainland. Multilevel logistic model was introduced to explore association between anorexia nervosa and suicidal thoughts. And subgroup analyses were conducted on participants with or without depression.ResultsMultilevel logistic model revealed that demographic variables, including academic achievement, were not the predictive risk factors of suicidal thoughts. Those who suffered from worse severity of perceived anorexia nervosa were at increased risk of thinking about suicide. The interaction between depression and anorexia nervosa was significant, however, subgroup analyses showed that the associations were significant only among the adolescents without depression.ConclusionsOur results indicate that all levels of anorexia nervosa serve as predictable indicators of suicidal thoughts in Chinese adolescents, and the effects of anorexia nervosa are modified by depression status.
Highlights
There is much literature on adolescent suicide, combined effects of depression and anorexia nervosa on suicide were rarely investigated
More than 20% of the students tried smoke and the same proportion would argue with their parents when parent-child conflict occurs. 70% of the respondents suffered from anorexia, at least some level. 12.22% considered suicide seriously, and 22.32% struggled with depression
Our results indicate that all levels of anorexia nervosa serve as indicators of remarkable suicidal thoughts, which consists with the results of several previous researches [15, 25,26,27,28]
Summary
There is much literature on adolescent suicide, combined effects of depression and anorexia nervosa on suicide were rarely investigated. The aims of this study are to examine the association between anorexia nervosa and suicidal thoughts and explore the interaction between anorexia nervosa and depression. Identifying subgroups of adolescents with suicidal thoughts could help guide suicide prevention initiatives, because existing studies indicate that suicidal ideation is the significant predictor of attempted suicide [7] and 60% of the suicide. It has been evidenced in many studies that anorexia nervosa is a serious psychiatric illness that is consistently associated with increased risk of suicide, especially in adolescents and young adults [9,10,11,12,13]. Most previous studies were based on clinical or community cohorts, the samples were small and focused on adults [9]
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