August 15, 2005 • www.familypracticenews.com Mental Health 33 Body Modification: Personal Art or Cry for Help?

BY BRUCE JANCIN ty history. So did the anatomic site they selected for al- Denver Bureau teration. For example, 27% of men and 46% of women with a B ROOMFIELD, COLO. — Body modification enthu- pierced eyebrow—a relatively common form of body siasts—individuals who undergo piercing, tattooing, modification—reported previously attempting suicide, and/or scarification—have a high rate of self-reported pri- compared with 18% of men and 32% of women without or suicide attempts, David Lester, Ph.D., said at the an- an eyebrow piercing, he said. nual conference of the American Association of Suici- Twenty-four percent of men with a tongue piercing dology. reported previously attempting suicide, compared with This observation from a large cross-sectional study of 18% of those without this body modification. Given the body art aficionados raises an intriguing very large sample size, that difference is question: Is body modification a marker ‘I would have highly statistically significant, Dr. Lester for increased risk of suicidality, or is it in- predicted a lesser said. stead a sort of substitute activity? Similarly, 37% of women with a pierced “As body modification is now becoming association tongue reported prior deliberate self-harm, socially acceptable, maybe it’s something with suicidality, compared with 30% without a pierced that high-risk adolescents could do to re- tongue. duce their suicidality, noted Dr. Lester, given how much Altogether, of 25 possible anatomic sites professor of psychology at Richard Stock- more popular for piercing, 9 were associated with in- ton College of New Jersey, Pomona. creased suicidality. “Of course, that’s a question that would tattoos have Tattoos at nine specific anatomic sites require a longitudinal controlled study to become since were associated with an increase in self-re- properly answer,” he said. ported suicide attempts. A detailed survey of some 4,700 indi- several decades “I would have predicted a lesser associa- viduals who frequent a Web site devoted ago.’ tion with suicidality, given how much more to hard-core body modification (www. popular tattoos have become since several bmezine.com) concluded that only 34% had never con- decades ago, when they were viewed as deviant,” Dr. sidered suicide. Lester observed. MAGES Thirty-nine percent of respondents indicated they had Some of the highest rates of suicidality were found I only contemplated suicide; 27% responded that they had among individuals who engaged in scarification. For ex- ETTY

made one or more attempts. ample, 39% of men and 48% of women with scarifica- ©G “That strikes me as high,” Dr. Lester said. tion of the upper arm or shoulder reported one or more Individuals who undergo body modification have a The median age of the survey respondents was 21 prior attempts at suicide, compared with 18% and 32%, high rate of self-reported prior suicide attempts. years. Eighty-eight percent were white, and roughly 45% respectively, without this particular body modification. were students. Frequenters of a Web site devoted to body modifica- All three rang true among the body modification Fifty-six percent of the body modification enthusiasts tion constitute a rather skewed survey population. crowd: Female respondents reported more suicidality described themselves as heterosexual, 38% bisexual, and As a sort of quick-and-dirty assessment of survey reli- than males, heterosexuals reported less extensive suici- only 5% homosexual. ability, Dr. Lester checked to see if three well-established dality histories than homosexuals or bisexuals, and indi- The type of body modification procedure individuals associations in the suicidology literature held true among viduals who said they have been depressed were more had undergone appeared to be related to their suicidali- respondents to the body modification survey. likely to report prior attempts at suicide. ■ Study Finds Lower Suicide Rates Not Due to Antidepressant Use

BY BRUCE JANCIN pact on the change in the total suicide rate The rate did decline over time in anti- notorious lethality in overdose. Denver Bureau during the second part of life. SSRIs have depressant-treated patients, but only min- The suicide rate actually rose slightly not worked as a prevention strategy on a imally—to a far lesser degree than in old- over time among Danes on atypical anti- B ROOMFIELD, COLO. — The steep universal level,” she added. er Danes not on such therapy. depressants. The most likely explanation rise in antidepressant prescribing over the She presented a 5-year follow-up cover- The suicide rate in individuals on tri- is that these newer medications were last several decades and the temporally as- ing the years 1996-2000 involving all of the cyclic antidepressants proved similar to largely reserved for patients who’d already sociated decline in suicide rates in many nearly 2.5 million Danes aged 50 years or that in SSRI-treated patients. This was a failed to respond to other antidepressant Western countries are not causally related, older. She also restricted her study, which surprising finding in light of the tricyclics’ classes. ■ Annette Erlangsen, Ph.D., said at the an- was based upon Danish national health nual conference of the registry data, to older Danes D A T A W A T C H American Association of ‘Results show that because suicide rates are Suicidology. the increased use highest in seniors, who also Her 5-year study of the consume proportionately Suicidal Ideation Is Down; Attempts Stay Level of SSRIs has not entire older population of the largest amount of SSRIs. Suicidal Ideation Denmark—with accompa- had an impact on During the study period, Female Male nying data on individual 1,430 older Danish men and 35 prescriptions filled for an- the change in the 710 older women committed Suicide Attempts Female Male tidepressants—showed total suicide rate suicide. The suicide rate fell 30 that the vast bulk of the from 35.4/100,000 among 25 drop in the Danish suicide during the second older men in 1996 to rate during the follow-up 27.1/100,000 in 2000. Simi- 20 ESIGN part of life.’ ,D period involved the 96% larly, the annual suicide rate 15 ELLER

of Danes not on an antidepressant. among older women dropped from 14.4 to K “These findings do not provide infor- 11.3/100,000. 10 ULIE mation on whether SSRIs [selective sero- A key finding in this study was that 90% /J tonin reuptake inhibitors] or other types of the decline in the suicide rate among Percentage of Students 5

of antidepressants prevent suicides on an older men and 76% of the decline in ESEARCH 0 individual level,” said Dr. Erlangsen of women was accounted for by individuals 1995 1997 1999 2001 2003 ,R Pennsylvania State University, University not on antidepressant, she continued. The Note: Data are based on a national sample of students in grades 9-12. Responses reflect the RANKI Park. suicide rate in persons on an antidepres- 12 months preceding the survey. F “Nevertheless, our results show that the sant was far higher than in those who Source: Centers for Disease Control and Prevention ICHARD increased use of SSRIs has not had an im- weren’t. R