text: Perceptions of a mental health questionnaire: the ethics of using population-based controls | Journal of Medical Ethics
  P J Surkan1,2,
  G Steineck1,3,
  U Kreicbergs1,4,5
  Clinical Cancer Epidemiology, Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden
  Department of Environmental Health, Exposure, Epidemiology, and Risk Program Landmark Center, Boston, MA, USA
  Department of Oncology, Division of Clinical Cancer Epidemiology, Sahlgrenska Academy, Sahlgrenska University Hospital, Göteborg, Sweden
  The Phyllis F. Cantor Center, Dana Farber Cancer Institute, Boston MA, USA
  Dr P Surkan, Exposure, Epidemiology and Risk Program, Harvard School of Public Health, Landmark Center, 401 Park Drive, 4th Floor West, Rm 415, Boston, MA 02215, USA; psurkan{at}hsph.harvard.edu
  Mental health surveys are used extensively in epidemiological research worldwide. The ethical questions that arise regarding their risk of causing psychological distress or other potential harm have not been studied in the general population. We have investigated how study participants serving as controls in a population-based study perceived an anonymous postal questionnaire focusing on mental health and wellbeing. Parents were contacted from the Swedish Census Bureau as part of a larger follow-up study on palliative care conducted in 2001. Eligible parents had a child of the same gender, year of birth and were from the same counties in Sweden as parents who had lost a child to cancer.
  Five percent reported being negatively affected. The principle negative effect on participants was that self-reflection reminded them of their difficulties. Of the 418 respondents, 52% reported that they were positively affected by study participation and 95% perceived the inquiry as valuable. These findings support the use of population-based controls in future research.
  http://dx.doi.org/10.1136/jme.2007.022418
  Funding: The study was supported by grants from the Thord-Gray Memorial Fund through the American-Scandinavian Foundation. This funding source had no involvement in any part of the study.