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Title: Higher Than Expected Suicides Found Among Swedish Women Who Had Breast Implants

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BMJ 2003;326:527-8.
03/06/2003 07:00:00 PM
By Harvey McConnell

Women who undergo breast augmentation surgery appear more likely to commit suicide than women from the general population, according to a prospective study among Swedish women. The 50% excess mortality found among 3,000 Swedish women who had breast enhancement surgery contrasts with decreased mortality which has been reported by researchers in the United States, researchers from Julius Centre for Health Sciences and Primary Care, University Medical Centre, Utrecht, The Netherlands, and Karolinska Institute, Stockholm, Sweden. The researchers identified a cohort of 3,521 Swedish women aged 15 to 69 who had breast implants over a 28-year period. They compared them with the expected number of deaths from suicide, unintentional injury, cardiovascular diseases, malignancies and other causes over an average of 11 years. Excluded from the analysis were women who had breast implants following treatment for breast cancer. There were 85 deaths in the cohort compared with the expected 58.7. In addition, 15 women in the cohort committed suicide, compared with an expected 5.2. Excess deaths were also due to malignant disease (1.4, 1.0-1.9), mainly lung cancer. Death rates from all other causes was close to expected rates, the researchers report. Differences between an increase in suicides among Swedish women and a decrease among America women reported in a U.S. study (Brinton et al. Epidemiology 2001 May;12(3):321-6) may reflect a difference between the two groups in the reasons for choosing plastic surgery, or may be an effect of losses to follow up in the US study. Both the American study and the Swedish study did, however, show an increased risk for suicide in women opting for breast augmentation, the researchers note. They conclude: "Given the well documented link between psychiatric disorders and a desire for cosmetic surgery, the increased risk for death from suicide may reflect a greater prevalence of psychopathology rather than a causal association between implant surgery and suicide. Surgeons evaluating candidates for breast implant surgery need to be vigilant for subtle signs of psychiatric problems."

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