American Journal of Epidemiology Advance Access originally published online on November 3, 2005
American Journal of Epidemiology 2006 163(1):1-8; doi:10.1093/aje/kwj002
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Original Contribution |
Association of Body Mass Index with Suicide Mortality: A Prospective Cohort Study of More than One Million Men
1 Department of Genetics and Pathology, Uppsala University, Uppsala, Sweden
2 Child and Adolescent Public Health Epidemiology Group, Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
3 Division of Epidemiology, Stockholm Centre of Public Health, Stockholm, Sweden
4 Department of Social Medicine, University of Bristol, Bristol, United Kingdom
Correspondence to Dr. Finn Rasmussen, Child and Adolescent Public Health Epidemiology Group, Department of Public Health Sciences, Karolinska Institute, Norrbacka, SE-171 76 Stockholm, Sweden (e-mail: finn.rasmussen{at}phs.ki.se).
The authors investigated the association of body mass index (BMI) with suicide in a record linkage study based on the Swedish Military Service Conscription Register, the Population and Housing Censuses, and the Cause of Death Register. The cohort studied consisted of 1,299,177 Swedish men who were conscripted in 1968–1999, had their BMI measured at age 18–19 years, and were followed up for as long as 31 years. A strong inverse association was found between BMI and suicide. For each 5-kg/m2 increase in BMI, the risk of suicide decreased by 15% (95% confidence interval: 9, 21). The association was similar when subjects with mental disorder at baseline were excluded from the analysis. BMI-suicide associations were similar in relation to suicide deaths occurring in the first 5 years of follow-up (hazard ratio for each 5-kg/m2 increase in BMI = 0.84, 95% confidence interval: 0.73, 0.96) compared with associations 
10 years after baseline (hazard ratio = 0.87, 95% confidence interval: 0.79, 0.96), indicating that weight loss as a consequence of mental illness does not explain the BMI-suicide association and that factors influencing BMI may be causally implicated in the etiology of mental disorders leading to suicide.
body mass index; cohort studies; medical record linkage; men; mortality; suicide
Abbreviations: BMI, body mass index; CI, confidence interval; ICD (8, 9, 10), International Classification of Diseases (Eighth Revision, Ninth Revision, Tenth Revision); MSCR, Military Service Conscription Register
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