Sunday, November 8, 2009

Patient Characteristics

Depression Disorder & Body Image

Women With Breast Implants More Likely to Commit Suicide

"In July of 2007, Sarwer et al. published a review article in The American Journal of Psychiatry investigating recent research linking breast augmentation and suicide. The studies revealed that the suicide rate of women who recieved cosmetic breast implants is approximately twice the expected rate based on estimates of the general population."

Several studies have been published concerning the disproportionate relationship between cosmetic surgery, specifically breast augmentation, and increased suicide rates among postoperative patients. In July of 2007, Sarwer et al. published a detailed review in The American Journal of Psychiatry, which revealed that women who received cosmetic breast implants were twice as likely to commit suicide when compared to the general population.

In choosing this article, which focuses specifically on cosmetic breast implantation, our group hopes to investigate the patient characteristics that predispose these patients to increased rates of suicide. The article describes this correlation in terms of specific patient qualities, motivations and expectations of patients who seek breast implants as a way of improving their social interaction and the way they feel about their bodies post surgery. When these expectations are not necessarily fulfilled, psychopathology results. Characteristics in prospective patients include more frequent alcohol and tobacco use, more sexual partners, higher use of oral contraceptives, having an abortion, eating disorders, and previous psychiatric hospitalizations. The highest risk factors are identified as having been hospitalized, alcohol consumption and tobacco use, and eating disorders.

The article references a study performed by Sarwer in 2004 that seems contradict many other studies that have been performed. Although this researcher found that patients report dissatisfaction with their body image, the studies mention that this dissatisfaction improves postoperatively. No actual statistics are provided which leads us to believe that the studies could be invalid, especially because the article goes on to mention a study by Cerand in 2005 which states that 90% of patients experienced either no change of a worsening of body dysmorphic disorder following breast augmentation surgery. A supporting study by Honigman in 2004 notes that there is no evidence that patients’ interpersonal relationships improve after surgery and that these unrealistic expectations and motivations are associated with poor postoperative outcomes.

It seems logical to think that postoperative dissatisfaction can potentially lead to depression, a disorder that is correlated with increased rates of suicide. Since these patients already exhibit suicidal risk factors prior to surgery, it appears as though many of these studies are logical. When we consider the unrealistic expectations, high cost of breast augmentation surgery and subsequent dissatisfaction with the procedure, it seems very realistic that emotionally unstable patients will exhibit higher suicide ideation rates.

It is interesting when we connect the facts and figures of this article within the realm of the pharmaceutical industry, specifically the market for antidepressants. Women are two times more likely than men to experience depression and it is estimated that nearly 7 million women suffer from some form of diagnosable depression in the United States. When you consider that number of these patients that are on antidepressant drugs, you can imagine the amount of revenue the pharmaceutical industry is generating. According to an analysis of the antidepressant drug market,,
the market reached sales of nearly 11 billion dollars in 2008. When we consider the side effects that result from such a high consumption of these synthetic drugs it sheds light on to how multidimensional and complex this problem truly is.

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