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Objective: To determine the association between adolescent hospitalization for suicide attempts and the subsequent risk of eating disorder hospitalization. Method: This was a cohort study of 162,398 adolescent girls in Quebec, Canada, including 7741 with suicide attempts before 20 years of age, matched to 154,657 adolescents with no attempt between 1989 and 2019. The main exposure measure was suicide attempt hospitalization. The main outcome measure was hospitalization for an eating disorder up to 31 years later, including anorexia nervosa, bulimia nervosa, and other eating disorders. We used adjusted Cox regression models to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between adolescent suicide attempts and eating disorder hospitalization. Results: Adolescent girls admitted for a suicide attempt had 5.55 times the risk of eating disorder hospitalization over time (95% CI 3.74–8.23), compared with matched controls. Suicide attempt was associated with anorexia nervosa (HR 3.57, 95% CI 1.78–7.17) and bulimia nervosa and other eating disorders (HR 8.55, 95% CI 5.48–13.32). Associations were pronounced in girls with repeated suicide attempts. Girls who attempted suicide through self‐poisoning had an elevated risk of anorexia nervosa, whereas girls who used violent methods such as cutting or piercing had a greater risk of bulimia nervosa and other eating disorders. Suicide attempt was strongly associated with eating disorder hospitalization in the year following the attempt, but associations persisted throughout follow‐up. Discussion: Suicide attempt admission is associated with the long‐term risk of eating disorder hospitalization in adolescent girls. Public Significance: This study of adolescent girls suggests that suicide attempt admission is associated with the long‐term risk of hospitalization for eating disorders. The risk is greatest in the year after the attempt, but persists over time. Adolescents who present with a suicide attempt may benefit from screening for eating disorders and long‐term follow‐up to help prevent the exacerbation or development of eating disorders. [ABSTRACT FROM AUTHOR]

This study assessed whether suicide attempts before 20 years of age were associated with medical morbidity later in life. We carried out a cohort study of 169,806 girls under age 20 years between 1989 and 2019 in Quebec, Canada. The cohort included 8086 girls admitted for suicide attempts, matched on age and year with 161,720 girls with no attempt. Outcomes included hospitalization for medical conditions, such as infection, allergic disorders, autoimmune disease, cardiovascular disease, cancer, and death from nonpsychiatric causes during 31 years of follow-up. We computed hazard ratios (HR) and 95% confidence intervals (CI) for the association of adolescent suicide attempt with these health outcomes using Cox regression models adjusted for preexisting mental illness, substance use disorders, and socioeconomic deprivation. Compared with matched controls, adolescent girls with suicide attempts had a greater risk of hospitalization for infection (HR 1.55, 95% CI 1.44–1.68), allergic disorders (HR 1.72, 95% CI 1.45–2.05), cardiovascular disease (HR 1.31, 95% CI 1.12–1.52), and mortality (HR 3.11, 95% CI 1.69–5.70). Associations were present regardless of the age at the time of the suicide attempt, but were stronger for girls with repeated attempts. Associations were also more pronounced within the first 5 years of the attempt, although suicide attempts remained strongly associated with mortality throughout the 31-year follow-up period. The findings suggest that adolescent girls with suicide attempts have an elevated risk of medical morbidity and mortality and may benefit from closer clinical management to prevent adverse health outcomes. • Adolescent girls with suicide attempts have a greater risk of morbidity later on. • Associations are present with infectious, allergic, and cardiovascular conditions. • Associations with these conditions are stronger in the first 5 years of follow-up. • Suicide attempt is associated with premature death over 31 years of follow-up. • There is no clear association with autoimmune disease and cancer. [ABSTRACT FROM AUTHOR]