Non‐suicidal self‐injury among individuals with an eating disorder: A systematic review and prevalence meta‐analysis

Author:

Kirkpatrick Ryan H.12ORCID,Breton Edith3ORCID,Biorac Aleksandar1ORCID,Munoz Douglas P.1ORCID,Booij Linda456ORCID

Affiliation:

1. Centre for Neuroscience Studies Queen's University Kingston Ontario Canada

2. Department of Medicine Queen's University Kingston Ontario Canada

3. Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction University of Oslo & Oslo University Hospital Oslo Norway

4. Eating Disorders Continuum, Douglas Mental Health University Institute Montreal West Island Integrated Health and Social Services Centre Montreal Quebec Canada

5. Department of Psychiatry McGill University Quebec Canada

6. Research Centre Douglas Mental Health University Institute Montreal Quebec Canada

Abstract

AbstractObjectiveThis study aimed to quantify the prevalence of non‐suicidal self‐injury across eating disorders (EDs) and within diagnostic categories through systematic review and proportional, or so‐called prevalence, meta‐analysis.MethodIncluded studies had to contain individuals with a verified diagnosis of an ED. The last literature search was conducted on September 11, 2023, for studies published on or before September 2023 without a restriction on earliest publication year. Results were synthesized and analyzed using the “metaprop” package in R and presented using forest plots. Bias was assessed by a Peters' regression test and funnel plot.Results79 studies published between 1985 and 2023 were included encompassing 32,334 individuals with an ED. Importantly, 42 studies were not included in any other meta‐analyses on self‐injury in EDs to date. Overall prevalence of non‐suicidal self‐injury was 34.59% (95%CI = 30.49–38.81). Prevalence in anorexia nervosa restrictive type, binge/purge type, bulimia nervosa, binge eating disorder and other specified feeding/eating disorder were 23.19% (95%CI = 16.96–30.03%), 41.98% (95%CI = 32.35–51.91%), 36.97% (95%CI = 30.69–43.46%), 21.21% (95%CI = 14.93–28.12%) and 37.65% (95%CI = 28.59–47.09%), respectively. Prevalence estimations could not be estimated for other ED categories due to lack of a sufficient number of studies.DiscussionNon‐suicidal self‐injury is prevalent across both binge/purge and restrictive EDs. Considering the transdiagnostic nature of self‐injurious behaviors in ED, the results highlight the importance of assessment and monitoring of self‐injury in people with ED, irrespective of specific diagnoses. The method of determining self‐injury varied across studies and may limit this study.Public SignificanceThis study highlights the prevalence of self‐injury across eating disorders irrespective of diagnosis and within specific EDs. While diagnoses known to exhibit self‐injurious behaviors (e.g., bulimia nervosa, anorexia nervosa binge/purge subtype) demonstrated the highest prevalence of self‐injury, all diagnoses were found to have a prevalence greater than 20%. These findings suggest the importance of assessing and monitoring all individuals with an eating disorder for the presence of self‐injury.

Funder

Canadian Institutes of Health Research

Elektrobit

Fonds de Recherche du Québec - Santé

Publisher

Wiley

Subject

Psychiatry and Mental health

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