Courses of suicidal ideation among military veterans in residential treatment for posttraumatic stress disorder.

Autor: Smith NB; VA Northeast Program Evaluation Center, Veterans Health Administration, West Haven, Connecticut.; Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut., Sippel LM; Executive Division, National Center for PTSD, White River Junction, Vermont.; Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire., Rozek DC; UCF RESTORES & Department of Psychology, University of Central Florida, Orlando, Florida., Spangler PT; Center for the Study of Traumatic Stress, Uniformed Service University, Bethesda, Maryland., Traber D; Department of Psychology, Université Grenoble Alpes, Université Savoie Mont Blanc, Grenoble, France., Straud CL; Department of Psychiatry, University of Texas Health Science Center San Antonio, San Antonio, Texas., Hoff R; VA Northeast Program Evaluation Center, Veterans Health Administration, West Haven, Connecticut.; Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.; Evaluation Division, National Center for PTSD, VA Connecticut Healthcare System, West Haven, Connecticut., Harpaz-Rotem I; VA Northeast Program Evaluation Center, Veterans Health Administration, West Haven, Connecticut.; Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.; Evaluation Division, National Center for PTSD, VA Connecticut Healthcare System, West Haven, Connecticut.; Clinical Neurosciences Division, National Center for PTSD, West Haven, Connecticut.
Jazyk: angličtina
Zdroj: Depression and anxiety [Depress Anxiety] 2020 Mar; Vol. 37 (3), pp. 273-284. Date of Electronic Publication: 2020 Jan 17.
DOI: 10.1002/da.22993
Abstrakt: Background: Suicidal thoughts are common among veterans with posttraumatic stress disorder (PTSD). The aim of this study was to examine the prevalence and correlates of four courses of suicidal (SI) among veterans receiving residential PTSD treatment.
Methods: A total of 1,807 veterans receiving residential PTSD treatment at Department of Veterans Affairs medical facilities who completed self-report measures at admission and discharge were included.
Results: The prevalence of SI courses were No SI (33.6%), Remitted SI (23.0%), SI onset (6.0%), and Chronic SI (37.4%). There were group differences between the four SI courses in PTSD symptoms at baseline, magnitude of PTSD symptom change during treatment, race/ethnicity and baseline depression, substance use, physical functioning, and pain. Chronic SI was associated with highest baseline PTSD, depression, substance use, pain and worse physical functioning. Remitted SI course was associated with greatest pre-posttreatment PTSD improvement, followed by No SI, Chronic SI, and SI Onset. Multinomial logistic regressions revealed that PTSD symptom improvement and baseline PTSD symptoms most consistently related to symptomatic SI courses compared to less symptomatic or No SI courses. Receipt of trauma-focused psychotherapy (none, some, or adequate) and length of stay were not related to SI courses and did not differ between groups.
Conclusions: Findings indicate that treating PTSD symptoms could be impactful for reducing suicidal thoughts. Although many veterans had remitted or reduced severity of SI at discharge, a significant proportion of veterans reported SI at discharge (43.4%), potentially highlighting the need for suicide specific treatment interventions within the context of PTSD treatment.
(Published 2020. This article is a U.S. Government work and is in the public domain in the USA.)
Databáze: MEDLINE
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