Abstract
PURPOSE: Patients with eating disorders show an elevated suicide risk compared to the general population. Adverse childhood experiences, depressive symptoms, and mental pain, often accompanied by hopelessness and demoralization, may increase this risk. This study aims to explore suicidal ideation and self-injurious behaviors in a heterogeneous sample of ED patients, and their association with childhood trauma and negative mental states. METHODS: 101 female patients were recruited from the inpatient and day hospital ED units at Policlinico Umberto I, Rome. Assessments included comorbid psychiatric diagnosis, suicide risk, mental pain, childhood trauma, depressive symptoms, hopelessness, and demoralization. RESULTS: Suicidal ideation in the past month was significantly associated with trait and state-level mental pain, self-reported sexual abuse, depression, hopelessness, and loss of meaning. In the multivariate model, only childhood sexual abuse and loss of meaning remained significantly associated. Self-injurious behaviors in the past 3 months were associated with trait-level psychache, self-reported sexual and physical abuse, and depression severity, however significantly associated with self-injurious behaviors in the multivariate model. CONCLUSIONS: Findings highlight the importance of assessing childhood trauma, especially sexual abuse, a low sense of meaning in life, depressive symptoms, and psychache in patients with EDs to improve suicide prevention strategies with specific interventions. Level of evidence III-Evidence obtained from well-designed cohort or case-control analytic studies.