Name : Chellya Fanny Alvionitan

NIM: 01071200025

Tutor : A26 Group: A26

Article 2 : High coffee Drinking Associated with Risk of Suicide

Please Read and discuss this article and write the Assignment:

1.Description of Place Person Time of Risk of Suicide

Place Person Time

Finlandia Male,Female 1972
Median age ( 25-64 year) 1977
Coffee drinker 1982
1986
1987
1992

2. Write EACH HYPOTESIS BY PLACE, PERSON, TIME AND EXPLANATION )

a. PLACE
Filandia have association with Risk of Suicide
Explanation:
According to trade statistics, the average annual consumption of coffee per capita in
Finland was 12.4 kg (corresponding to 4 cups/day) in 1994, which is the highest amount in the
world. The suicide rate of the Finns is also high internationally,and the rate has constantly
increased during the recent decades.

b. PERSON
 25- 64 Years have association with Risk of Suicide
For each survey, an independent random sample of subjects aged 25±64 years was drawn from
the National Population Register. The participation rates varied from 69 to
96% by survey year, gender, and area.From the survey daily coffee drinking had a J-shaped
association with the risk of suicide The age-adjusted risks (with 95% CI's) of suicide were 1.00,
0.67 (0.38±.20), 0.82 (0.48±1.37), 0.82 (0.48±1.39), 1.32 (0.74±
2.37) and 1.69 (0.96±2.98), in the six coffee drinking categories, respectively.

 Heavy Coffee drinker have association with Risk of Suicide

heavy coffee drinking was significantly associated with mortality from suicide.There was a 58%
higher relative risk (RR: 1.58, 95% CI's: 1.02±2.42; p 0.039) of suicide among heavy (P8
cups/day) coffee drinkers compared with more moderate drinkers. Cafeine is an addictive
psychoactive substance, and heavy caffeine increases nervousness, fear, tension, palpita,
restlessness, tremors, and may induce subject rated anxiety and panic attacks in sensitive normal
subjects .Acute intake of large amounts of cafeine may increase psychoses and hostility.This
effect can lead to risk of suicide.

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c. TIME

1972,1977,1982,1987,1992 have association with Risk of Suicide

Analyze from the article, people in finland was asked with an open question about how much
caffein they consume daily .

2. HIPOTESIS: Heavy Coffee Drinking and the Risk of Suicide

Heavy coffee drinking lead to lack of sleep and excessive tiredness that cause suicide.

3. TYPE OF POSSIBLE ASSOCIATION

A. IS IT POSSIBLE THIS ASSOCIATION IS HAPPEN BY CHANCE?

Yes, it is possible that this association is happen by chance. This can happen because the
research was carried in Finland. In addition, the concentration of coffee in Finland is known to
be stronger than usually consumed in USA.

B. IS IT POSSIBLE THIS ASSOCIATION IS HAPPEN BECAUSE OF BIAS?

Yes, it is possible that this association is happen because of bias. In my opinion, there are several
bias found in this case. First of all, measurement bias. Measurement bias can occur because the
amount of caffeine consume by person in every cup might be different. Second, information bias.
Information bias happens because the cause of suicide reported by National Death Register
might not be caused by caffeine. Based on the article, National Death Register does not provide
enough information that prove the suicide is caused by caffeine. In my opinion, recall bias may
happen here. For instance, people who answer the questionnaire may give false information
about how much caffeine they consume in the week. Selection bias may happen because the
survey only research about suicide case because of coffee drinking in Finland.

C. CONFOUNDING?

The third factor is mental health. Globally, more than 300 million people suffer from mental
health, the leading cause of disability (WHO, 2017). In the US, the suicide mortality rate
increased by 24% from 1999 to 2014, particularly among middle-age adults. The suicide
mortality rate in US working populations has been also on the rise.

In this article, there is no control lifestyle of people who were being surveyed. This information
is supported by the fact that the article only provide an open question about how many cups of
coffee they usually drink.

D. REVERSE TIME ORDER ? WHY Not? Why Yes?

Yes, suicide thoughts can lead people to drink coffee. Drinking several cups of coffee daily
appears to reduce the risk of suicide in men and women by about 50 percent, according to a new

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study by researchers at the Harvard School of Public Health (HSPH). The study was published
online July 2 in The World Journal of Biological Psychiatry.In this research found that Caffeine
not only stimulates the central nervous system but may act as a mild antidepressant by boosting
production of certain neurotransmitters in the brain, including serotonin, dopamine, and
noradrenaline. This could explain the lower risk of depression among coffee drinkers that had
been found in past epidemiological studies, the researchers reported.

E. CAUSAL ?

In fact, caffeine produces dopamine, serotonin and melatonin. Based on Department of

Psychology, University of Valencia, Spain research Dopamine cause coffee drinker to feel happy
and confidence. While melatonin prevents coffee drinker to feel sleepy. These can lead to lack of
sleep and excessive fatigue. Person then develops depression, anxiety, and suicide thoughts.

4. CHOOSE ONE OF THE BEST ASSOCIATION (EXPLANATION)

a. Chance b. Bias c. Confounding d. Reverse Time Order e. Causal

D. Reverse Time Order

In my opinion, the stress leads people to drink coffee. This is supported from my statement
above, I think that people has some problems in their life and need to relief their stress. Many
research has proven that caffeine can help. With consumption of caffeine , suicidal thoughts are
relief because person who drinks coffee can control their stress.

5. Write down 2 PREVENTION/POLICY (PRACTICAL) TO PREVENT THE RISK OF

SUICIDE or Write down 2 Prevention for this design study/methodology

1. Seek for help if you are thinking of suicide

2. Consume the right amount of caffeine which is up to 400mg or 4 cups of brewed coffee.

Source:

https://news.harvard.edu/gazette/story/2013/07/drinking-coffee-may-reduce-risk-of-suicide-by-
50/

https://www.longdom.org/open-access/happiness-role-of-dopamine-and-serotonin-on-mood-and-
negative-emotions-2165-7548-1000350.pdf

https://www.psypost.org/2017/03/dysregulation-dopamine-receptors-linked-suicide-study-finds-
48093#:~:text=Dysregulation%20of%20dopamine%20receptors%20linked%20to%20suicide

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%2C%20study%20finds,-By%20Eric%20W&text=New%20research%20published%20in
%20Neuropsychopharmacology,tissue%20from%2034%20deceased%20individuals.