An umbrella review synthesising published systematic review evidence for self-harm and suicidality among patients diagnosed with an eating or feeding disorder
摘要
In recent years there has been a proliferation of systematic reviews on the association between feeding and eating disorders and self-harm and suicidality. This study aims to conduct an umbrella review, providing a top-level synthesis of this information. A systematic search was performed using two databases (MEDLINE and APA PsycInfo), with inclusion criteria of studies identifying as systemic reviews, written in English, and researching the association between feeding and eating disorders and self-harm and/or suicidality. The Joanna Briggs Institute (JBI) Critical Appraisal tools for JBI systematic reviews was used to assess the quality of the included studies. A total of 14 systematic reviews and meta-analyses, 10 systematic reviews accompanied by meta-analyses (4 standalone systematic reviews and 10 systematic reviews and meta-analyses) were included in the umbrella review. A strong prevalence between non-suicidal self-injury, suicidal ideation and suicide attempts was found, emphasising the importance of sufficient self-harm and suicidality screening measures for patients with feeding and eating disorders. The binging-purging subtype of anorexia nervosa was identified as independently associated with suicide attempts, and higher levels of impulsivity. The integrated motivational-volitional model can be used as a basis for comparing the progression to suicidality in patients with and without feeding and eating disorders, allowing more clarity on if and how this differs. This review found the onset of feeding and eating disorder and self-harm and suicidal behaviours can vary between the individual and suggests this may be due to different reasons for engaging in a feeding and eating disorder, self-harm, and suicidal behaviours specific to the individual. The interplay between feeding and eating disorders and self-harm and suicidality remains largely unclear, and further longitudinal research within this area is needed.