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Multicenter Study
. 2025 Mar 5;30(1):21.
doi: 10.1007/s40519-025-01728-1.

Non-suicidal self-injury among women hospitalised for anorexia nervosa

France Hirot  1   2 , Aminata Ali  3   4 , Corinne Blanchet  3   5 , Salomé Grandclerc  3   5 , Ludovic Gicquel  6   7 ; EVHAN group; Sylvie Berthoz  8   9 , Nathalie Godart  3   4   10
Collaborators, Affiliations
Multicenter Study

Non-suicidal self-injury among women hospitalised for anorexia nervosa

France Hirot et al. Eat Weight Disord. .

Abstract

Introduction: Non-suicidal self-injury (NSSI) is frequent in eating disorders (ED). The aim of this study was to describe NSSI among subjects hospitalised for anorexia nervosa (AN) who self-harm and factors associated with NSSI in this population.

Methods: This study was part of a larger French longitudinal multi-centre study. Two hundred and two women with AN were recruited from inpatient treatment facilities for ED from 2009 to 2011. All participants fulfilled the DSM-5 diagnostic criteria of AN. Subjects with and without NSSI were compared for clinical characteristics and comorbidities in bivariate analyses. Logistic regression analysis was then used to identify factors associated with NSSI.

Results: The mean age of the sample was 20.8 years (± 6.6). The mean BMI was 14.3 (± 1.5). Overall 36.1% had self-harmed in the past 6 months. The main factors that triggered NSSI were a feeling of physical or psychological unease (45.2%), feelings of anger (24.7%), an attempt to relieve discomfort (19.2%), and low self-esteem (16.4%). Lifetime major depressive disorder, suicide attempts and eating concerns were independently associated with NSSI.

Discussion: ED symptoms were linked to NSSI, but psychiatric history also played a key role. This is consistent with hypotheses of common underlying transdiagnostic mechanisms linking emotional dysregulation to NSSI and ED.

Level of evidence: Level III, well-designed cohort or case-control analytic studies.

Keywords: Anorexia nervosa; Mood disorders; Non-suicidal self-injury; Suicide.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study protocol was approved by the Ile-de-France III Ethics Committee and the French Data Protection Authority (Commission Nationale de l’Informatique et des Libertés, CNIL). EudraCT number: 2007-A01110-53, Clinical trials number: NCT00910169. In accordance with the Helsinki declaration, written informed consent was obtained before inclusion from each participant, as well from their parents for those who were under 18 years. Competing interests: The authors declare no competing interests.

Figures

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References

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    1. Arnold S, Wiese A, Zaid S, Correll CU, Jaite C (2022) Lifetime prevalence and clinical correlates of nonsuicidal self-injury in youth inpatients with eating disorders: a retrospective chart review. Child Adolesc Psychiatry Ment Health 16:17 - PMC - PubMed
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    1. Radon L, Lam CBK, Letranchant A, Hirot F, Guillaume S, Godart N (2022) Bipolar disorders in severe anorexia nervosa: prevalence and relationships. Eat Weight Disord 27:1063–1075 - PubMed

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