A new study adds to evidence that women with cosmetic breast implants have a higher rate of suicide than other women and shows, for the first time, that they may be more likely to have a history of psychiatric illness as well.

Whether the elevated rate of psychiatric conditions explains the higher suicide risk is not clear from the findings. However, the study does give weight to the belief that it’s not the cosmetic procedure itself that is behind patients’ suicides, according to Dr. Joseph K. McLaughlin, president of the International Epidemiology Institute, a Rockville, Maryland-based research center founded by scientists from the National Cancer Institute.

“There is no evidence that breast implants, per se, increase the risk of suicide,” he told Reuters Health.

Mounting evidence indicates that, for whatever reason, there is a “small subset” of breast-implant patients who are at risk of suicide, according to McLaughlin. His team’s study adds to past research that has consistently found a two- to three-times higher risk of suicide among women with cosmetic breast implants compared with the general population.

The “new twist” from this study, McLaughlin said, is the additional finding on psychiatric hospital admissions. Compared with women who underwent either breast reduction or other cosmetic procedures, those who received breast implants were 70 percent more likely to have a history of admissions for psychiatric illness.

The findings are published in the current issue of the Archives of Internal Medicine.

The study included nearly 2,800 Danish women who underwent cosmetic breast-implant surgery between 1973 and 1995, as well as more than 7,000 women who had breast reduction and 1,700-plus women who had other types of cosmetic surgery within the same time period.

The researchers used national records to gather information on the women’s death rates and causes of death through 1999, and on their history of hospitalization for psychiatric illness prior to having cosmetic surgery.

Overall, McLaughlin and his colleagues found, 14 women with breast implants committed suicide. While that number is small, it makes for a suicide rate that’s three-times higher than the norm, according to the researchers.

In addition, eight percent of the women with breast implants had had a psychiatric hospital admission - a “hard” measure, McLaughlin noted, that indicates mental illness and not problems such as poor body image. That rate of hospital admission compares with a roughly five-percent rate in each of the two comparison groups.

The researchers also found that women who underwent breast reduction had a higher-than-expected rate of suicide - a finding McLaughlin called “surprising.”

However, he pointed out that this increased risk was “barely significant” in statistical terms, and therefore could be a chance finding.

“It certainly needs further evaluation,” McLaughlin said.

On the other hand, he added, the suicide risk among women with breast implants seems to be a solid finding. McLaughlin said that with all the research that has looked into the possible links between breast implants and serious illness, including autoimmune disorders such as rheumatoid arthritis and lupus, the only risk that has consistently emerged is the risk of suicide.

“It’s unexplained for now,” he said.

Still, given the new findings on psychiatric illness, McLaughlin said it may be a good idea for plastic surgeons to “take a closer look” at breast-implant candidates and possibly refer those with signs of a psychiatric problem for evaluation.

The study was funded by the Danish Cancer Society and the International Epidemiology Institute, which received support from the Dow Corning Corporation, once the world’s largest maker of silicone gel breast implants. The company no longer makes the implants, having been hit in the 1990s with thousands of lawsuits claiming that the devices caused health problems.

SOURCE: Archives of Internal Medicine, December 13/27, 2004.