Suicide and Cardiovascular Death after a Cancer Diagnosis

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Abstract
Fang et al. (April 5 issue)1 report an increased risk of suicide after a cancer diagnosis and discuss their finding mainly in terms of psychological stress after receiving such a diagnosis. However, acute psychological distress is only a proximal factor influencing suicide risk. Personality and cognitive characteristics such as impulsivity, aggression, and impaired decision making are known endophenotypes of predisposition to suicide.2 Information on previous hospitalization for any mental disorder is not discriminative enough in this context. One study from Sweden showed that only one third of male and half of female suicide victims had been hospitalized during the 5 years before suicide.3

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