Citation

Didie ER, Phillips KA. Am. J. Epidemiol. 2007; 165(7): 846; author reply 846-7.

Affiliation

Brown Medical School, Providence, RI 02906 (Elizabeth_Didie@brown.edu)

Comment On:

Am J Epidemiol 2006;164(4):334-41.

Copyright

(Copyright © 2007, Oxford University Press)

DOI

10.1093/aje/kwk120

PMID

17308331

Abstract

The recent article by Villeneuve et al., which reported an increased suicide rate among women who received breast implants or other cosmetic surgery compared with the general population, is timely and important. Four previous studies have also reported increased suicide rates among women who received breast implants for augmentation purposes. The reasons for this association are unclear. As noted by Villeneuve et al., some studies found that women with breast implants who commit suicide are more likely to have had psychotherapy and more likely to have lower self-esteem and self-confidence, increased levels of depression, and an increased prevalence of mental illness as measured by psychiatric hospitalizations.

We would like to raise the possibility that some of these women may have had body dysmorphic disorder (BDD). It is important that future studies consider BDD as a risk factor for suicide in women who receive breast implants or other cosmetic procedures. This may be challenging, however, as many patients with BDD do not disclose their symptoms, and BDD often goes undiagnosed. Epidemiologic studies that use existing medical records and databases will likely underreport BDD's prevalence and miss a potential link among BDD, receipt of breast implants, and suicide. Prospective, longitudinal studies in which BDD is specifically asked about and identified are needed to shed light on this important issue.

Language: en