Study of Males: Once Short, Always at Risk for Suicide
> 1/22/2008 10:35:23 AM

Even if a troubled person leaves behind a suicide note, the reasons for their abnegation of life are difficult to fully understand. Researchers are looking for genetic predispositions and emotional triggers that can warn loved ones to intervene before it is too late. This search led Dr. Mittendorfer-Rutz to the unexpected finding that low height is a strong suicide risk factor throughout the life of a male. His surprising study appears in this year’s first issue of the Journal of Epidemiology and Community Health.

The link between height and suicide has been explored in previous studies, but many early results turned out to be invalid because researchers failed to adjust for the correlation between height and socioeconomic status. Then in a 2005 article in the American Journal of Psyschiatry, Dr. Magnusson examined conscription data from Sweden and found that even when education level is controlled for, there is a strong inverse correlation between height and suicide. While education level is not the same as socio-economic status, there is considerable overlap. Dr. Magnusson posited a number of possible explanations for this correlation: discrimination, a more general link between mental problems and height, stress or nutritional deficits during childhood.

This year, Dr. Mittendorfer-Rutz expanded on Dr. Magnusson’s work by using an even larger, 318,953 person set of Swedish conscription data and combining that with birthweight data. He not only confirmed that shortness corresponds with all types of suicide, but that both shortness at adulthood and shortness at birth confer a risk. Babies born with below-average height were 2.39 times as likely to attempt violent suicide even when they reached average height during maturation. This makes the discrimination theories of Dr. Magnusson less likely, and points towards a genetic or fetal-development problem. Short adults were 1.56 times as likely to attempt violent suicide, suggesting that congenital problems either improve but still persist, or that discrimination is a less powerful but still significant factor separate from problems at birth.

Another possible clue is that violent suicide (committed with a weapon, vehicle, rope, etc.) turned out to have a higher correlation with height than suicide in general. There are no satisfactory explanations for this difference, though a speculative 1995 paper in the British Medical Journal hypothesized that obstetric complications raise suicide risk by forging an early pain associations in the baby brain. Dr. Mittendorfer-Rutz makes the tentative suggestion that serotonin, which mediates both aggression and impulsivity, may explain the correlation.

The sample size from the latest Swedish study is so large both objectively and relative to the national population (because military service is mandatory for men) that the correlation cannot be attributed to misleading anomalies in the data. However, as females were excluded from the study, it is not clear whether the discovered correlation is independent of sex. Females should be included in further studies because they face far less derision for shortness and could rule out or confirm height discrimination as a primary cause of suicide.

While we wait for explanations, we must use this information to take extra care with men who are short or were born short. Being short or having had a low birth-height doesn't preclude anyone from living a full and happy life, but individuals will differ widely, and we see in this study that on average, the short man is more likely to violently take his own life, at least in Sweden, and family members and doctors should be aware of this increased risk. Previously, all the worry was focused on low birth weight, but now we know that multiple aspects of body shape can have significant effects later in life.

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