WhatFinger

Journal of Affective Disorders, anorexia nervosa

Anorexia and Suicides; a Sadly Emphatic Link


By Guest Column Joshua Hill——--March 11, 2008

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Recently Time ran a story focusing on new research which has shown that suicide in those suffering from anorexia nervosa (AN) is often attempted much more effectively than others.

It comes as not much of a surprise, however it represents what Time described as a “landmark shift in how doctors understand suicidal tendencies” in those of their patients that suffer from anorexia. As an Australian, I am a member of a country which is continually growing in size; and by that, I mean we are getting fatter and fatter. However I remember back to when I was younger and one of our current affairs programs – when it still had a shred of pride – followed a young girl named Bronte Cullis, who suffered dramatically from anorexia. It was a shocking sight, and one that immediately centered Australia’s attention on the young girl and those who suffered similarly. To be published in this spring’s Journal of Affective Disorders, the research looked at whether suicide attempts in those suffering from anorexia were because their bodies were already dangerously unhealthy that any attempt would kill them; or that they used highly lethal techniques. Looking at nine case reports from individuals with AN from Germany and Boston, the researchers found that those who suffered from AN might actually familiarize themselves with pain, and thus use a method of suicide which is both extremely painful and thus lethal. "We established that these patients' death had little to do with their low body weight," says lead author Jill Holm-Denoma, a professor of clinical psychology at Vermont and an expert on treating eating disorders. "The methods that they chose could have killed anyone." The means used to achieve death by those focused upon in the study are truly horrific. But what is worse is that they are not calls for help, but the end of the line for them. From ingesting highly toxic chemicals, to jumping in front of a moving train and hanging oneself, these successful suicides often came after many failed attempts. A previous study of about 250 women suffering from anorexia in 2003 at Harvard University showed that the risk of death by suicide among anorexic women was 57 times what would be expected from a healthy woman. Other studies exist, but Holm-Denoma’s study was the only one to focus on the methods. As such, it backed up a 2006 study by Thomas Joiner at Florida State University which posited the above view that these women are more attuned to pain. The gruesome nature of the deaths, along with the way that each of the case studies so totally isolated themselves at the time, left little doubts in the researchers minds that these women wished to die. Possibly the most important thing to be taken away from this study is for doctors who are treating those who have attempted suicide and suffer from AN. If their attempts were particularly vicious or painful, immediate action must be taken; it becomes almost like a chart by which to categorize someone’s state of mind. "The likelihood of whether a patient wants to lethally hurt herself must be assessed right away," Holm-Denoma says, adding, "Addressing psychiatric needs must be paramount." Furthermore, this research once again manages to highlight the failures of medical health insurance companies. Anorexia is most often argued as being a mental health problem, and thus not picked up by most health insurance companies. Those plans that do allow for treatment often restrict it to simply pushing someone’s weight back up to an acceptable level before ceasing funding; at which point the burden of cost is either taken up by the family or, in most cases, the patient is discharged. This, however is simply not good enough. "The biological crisis may have passed," says Barbara Anthony, a Boston-based lawyer and executive director of Health Law Advocates, an organization that aids families. "But hospitals and health plans have done little to provide these patients with the mental health care they desperately need." Either way you look at this research, it is obvious to even the most ignorant bureaucrat, that more must be done. A Geek’s-Geek from Melbourne, Australia, Josh is an aspiring author with dreams of publishing his epic fantasy, currently in the works, sometime in the next 5 years. A techie, nerd, sci-fi nut and bookworm

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Guest Column——

Items of notes and interest from the web.


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