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Objective: This 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. Method: Included 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. Results: 79 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. Discussion: Non‐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 Significance: This 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. [ABSTRACT FROM AUTHOR]

Supplemental digital content is available in the text. Learning objective: After participating in this activity, learners should be better able to: • Evaluate the evidence regarding the effectiveness of long-term treatment of bipolar disorder with valproate Background: Prophylactic treatment is critical for bipolar disorder (BD) patients. Valproate is commonly used for this purpose but lacks regulatory approval and carries appreciable risks. Methods: Systematic literature searching through June 2020 sought prospective trials lasting ≥12 months with adults diagnosed with BD to support comparisons of risk of new illness episodes with valproate versus placebo or other agents. Results: Included were 13 reports involving 9240 subjects treated for an average of 29.1 months (range, 12–124) in 21 trials: 9 were blinded, randomized trials (RCTs) of valproate versus placebo (n = 3), lithium (5), or olanzapine (1); 2 were unblinded RCTs versus lithium (1) or quetiapine (1); and 10 were open-label trials versus lithium (5), quetiapine (2), carbamazepine (1), lamotrigine (1), or olanzapine (1). Random-effects meta-analysis found valproate superior to placebo in 3 trials (odds ratio [OR] = 0.42 [95% confidence level (CI), 0.30–0.60]; p <.0001). In 11 trials, protective effects with valproate and lithium were similar (OR = 1.20 [CI, 0.81–1.79]; p =.36), as well in 5 comparisons versus antipsychotics quetiapine and olanzapine (OR = 0.96 [CI, 0.66–1.40]; p =.84), and 2 versus other mood-stabilizing anticonvulsants (carbamazepine and lamotrigine) (OR = 1.30 [CI, 0.75–2.26]; p =.34). Valproate was nonsignificantly more effective versus new mania than depression (χ2 = 3.03; p =.08). Conclusions: Valproate was more effective than placebo in preventing new BD episodes of mania or depression, and not significantly different from lithium, second-generation antipsychotics, or other anticonvulsants. Overall benefits were nonsignificantly greater versus mania than bipolar depression. [ABSTRACT FROM AUTHOR]