Predictors of Suicide Attempt Within 30 Days After First Medically Documented Suicidal Ideation in U.S. Army Soldiers.

Autor:	Mash HBH; Center for the Study of Traumatic Stress, Department of Psychiatry (Mash, Ursano, Naifeh, Fullerton, Aliaga, Riggs-Donovan, Dinh, Vance, Wynn), and Department of Preventive Medicine and Biostatistics (Kao), Uniformed Services University of the Health Sciences, Bethesda, Md.; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Md. (Mash, Naifeh, Aliaga, Riggs-Donovan, Dinh, Vance); Department of Health Care Policy, Harvard Medical School, Boston (Kessler, Zaslavsky, Sampson); Departments of Psychiatry and Family Medicine and Public Health, University of California, San Diego, and VA San Diego Healthcare System, San Diego (Stein)., Ursano RJ; Center for the Study of Traumatic Stress, Department of Psychiatry (Mash, Ursano, Naifeh, Fullerton, Aliaga, Riggs-Donovan, Dinh, Vance, Wynn), and Department of Preventive Medicine and Biostatistics (Kao), Uniformed Services University of the Health Sciences, Bethesda, Md.; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Md. (Mash, Naifeh, Aliaga, Riggs-Donovan, Dinh, Vance); Department of Health Care Policy, Harvard Medical School, Boston (Kessler, Zaslavsky, Sampson); Departments of Psychiatry and Family Medicine and Public Health, University of California, San Diego, and VA San Diego Healthcare System, San Diego (Stein)., Kessler RC; Center for the Study of Traumatic Stress, Department of Psychiatry (Mash, Ursano, Naifeh, Fullerton, Aliaga, Riggs-Donovan, Dinh, Vance, Wynn), and Department of Preventive Medicine and Biostatistics (Kao), Uniformed Services University of the Health Sciences, Bethesda, Md.; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Md. (Mash, Naifeh, Aliaga, Riggs-Donovan, Dinh, Vance); Department of Health Care Policy, Harvard Medical School, Boston (Kessler, Zaslavsky, Sampson); Departments of Psychiatry and Family Medicine and Public Health, University of California, San Diego, and VA San Diego Healthcare System, San Diego (Stein)., Naifeh JA; Center for the Study of Traumatic Stress, Department of Psychiatry (Mash, Ursano, Naifeh, Fullerton, Aliaga, Riggs-Donovan, Dinh, Vance, Wynn), and Department of Preventive Medicine and Biostatistics (Kao), Uniformed Services University of the Health Sciences, Bethesda, Md.; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Md. (Mash, Naifeh, Aliaga, Riggs-Donovan, Dinh, Vance); Department of Health Care Policy, Harvard Medical School, Boston (Kessler, Zaslavsky, Sampson); Departments of Psychiatry and Family Medicine and Public Health, University of California, San Diego, and VA San Diego Healthcare System, San Diego (Stein)., Fullerton CS; Center for the Study of Traumatic Stress, Department of Psychiatry (Mash, Ursano, Naifeh, Fullerton, Aliaga, Riggs-Donovan, Dinh, Vance, Wynn), and Department of Preventive Medicine and Biostatistics (Kao), Uniformed Services University of the Health Sciences, Bethesda, Md.; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Md. (Mash, Naifeh, Aliaga, Riggs-Donovan, Dinh, Vance); Department of Health Care Policy, Harvard Medical School, Boston (Kessler, Zaslavsky, Sampson); Departments of Psychiatry and Family Medicine and Public Health, University of California, San Diego, and VA San Diego Healthcare System, San Diego (Stein)., Aliaga PA; Center for the Study of Traumatic Stress, Department of Psychiatry (Mash, Ursano, Naifeh, Fullerton, Aliaga, Riggs-Donovan, Dinh, Vance, Wynn), and Department of Preventive Medicine and Biostatistics (Kao), Uniformed Services University of the Health Sciences, Bethesda, Md.; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Md. (Mash, Naifeh, Aliaga, Riggs-Donovan, Dinh, Vance); Department of Health Care Policy, Harvard Medical School, Boston (Kessler, Zaslavsky, Sampson); Departments of Psychiatry and Family Medicine and Public Health, University of California, San Diego, and VA San Diego Healthcare System, San Diego (Stein)., Riggs-Donovan CA; Center for the Study of Traumatic Stress, Department of Psychiatry (Mash, Ursano, Naifeh, Fullerton, Aliaga, Riggs-Donovan, Dinh, Vance, Wynn), and Department of Preventive Medicine and Biostatistics (Kao), Uniformed Services University of the Health Sciences, Bethesda, Md.; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Md. (Mash, Naifeh, Aliaga, Riggs-Donovan, Dinh, Vance); Department of Health Care Policy, Harvard Medical School, Boston (Kessler, Zaslavsky, Sampson); Departments of Psychiatry and Family Medicine and Public Health, University of California, San Diego, and VA San Diego Healthcare System, San Diego (Stein)., Dinh HM; Center for the Study of Traumatic Stress, Department of Psychiatry (Mash, Ursano, Naifeh, Fullerton, Aliaga, Riggs-Donovan, Dinh, Vance, Wynn), and Department of Preventive Medicine and Biostatistics (Kao), Uniformed Services University of the Health Sciences, Bethesda, Md.; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Md. (Mash, Naifeh, Aliaga, Riggs-Donovan, Dinh, Vance); Department of Health Care Policy, Harvard Medical School, Boston (Kessler, Zaslavsky, Sampson); Departments of Psychiatry and Family Medicine and Public Health, University of California, San Diego, and VA San Diego Healthcare System, San Diego (Stein)., Vance MC; Center for the Study of Traumatic Stress, Department of Psychiatry (Mash, Ursano, Naifeh, Fullerton, Aliaga, Riggs-Donovan, Dinh, Vance, Wynn), and Department of Preventive Medicine and Biostatistics (Kao), Uniformed Services University of the Health Sciences, Bethesda, Md.; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Md. (Mash, Naifeh, Aliaga, Riggs-Donovan, Dinh, Vance); Department of Health Care Policy, Harvard Medical School, Boston (Kessler, Zaslavsky, Sampson); Departments of Psychiatry and Family Medicine and Public Health, University of California, San Diego, and VA San Diego Healthcare System, San Diego (Stein)., Wynn GH; Center for the Study of Traumatic Stress, Department of Psychiatry (Mash, Ursano, Naifeh, Fullerton, Aliaga, Riggs-Donovan, Dinh, Vance, Wynn), and Department of Preventive Medicine and Biostatistics (Kao), Uniformed Services University of the Health Sciences, Bethesda, Md.; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Md. (Mash, Naifeh, Aliaga, Riggs-Donovan, Dinh, Vance); Department of Health Care Policy, Harvard Medical School, Boston (Kessler, Zaslavsky, Sampson); Departments of Psychiatry and Family Medicine and Public Health, University of California, San Diego, and VA San Diego Healthcare System, San Diego (Stein)., Zaslavsky AM; Center for the Study of Traumatic Stress, Department of Psychiatry (Mash, Ursano, Naifeh, Fullerton, Aliaga, Riggs-Donovan, Dinh, Vance, Wynn), and Department of Preventive Medicine and Biostatistics (Kao), Uniformed Services University of the Health Sciences, Bethesda, Md.; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Md. (Mash, Naifeh, Aliaga, Riggs-Donovan, Dinh, Vance); Department of Health Care Policy, Harvard Medical School, Boston (Kessler, Zaslavsky, Sampson); Departments of Psychiatry and Family Medicine and Public Health, University of California, San Diego, and VA San Diego Healthcare System, San Diego (Stein)., Sampson NA; Center for the Study of Traumatic Stress, Department of Psychiatry (Mash, Ursano, Naifeh, Fullerton, Aliaga, Riggs-Donovan, Dinh, Vance, Wynn), and Department of Preventive Medicine and Biostatistics (Kao), Uniformed Services University of the Health Sciences, Bethesda, Md.; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Md. (Mash, Naifeh, Aliaga, Riggs-Donovan, Dinh, Vance); Department of Health Care Policy, Harvard Medical School, Boston (Kessler, Zaslavsky, Sampson); Departments of Psychiatry and Family Medicine and Public Health, University of California, San Diego, and VA San Diego Healthcare System, San Diego (Stein)., Kao TC; Center for the Study of Traumatic Stress, Department of Psychiatry (Mash, Ursano, Naifeh, Fullerton, Aliaga, Riggs-Donovan, Dinh, Vance, Wynn), and Department of Preventive Medicine and Biostatistics (Kao), Uniformed Services University of the Health Sciences, Bethesda, Md.; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Md. (Mash, Naifeh, Aliaga, Riggs-Donovan, Dinh, Vance); Department of Health Care Policy, Harvard Medical School, Boston (Kessler, Zaslavsky, Sampson); Departments of Psychiatry and Family Medicine and Public Health, University of California, San Diego, and VA San Diego Healthcare System, San Diego (Stein)., Stein MB; Center for the Study of Traumatic Stress, Department of Psychiatry (Mash, Ursano, Naifeh, Fullerton, Aliaga, Riggs-Donovan, Dinh, Vance, Wynn), and Department of Preventive Medicine and Biostatistics (Kao), Uniformed Services University of the Health Sciences, Bethesda, Md.; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Md. (Mash, Naifeh, Aliaga, Riggs-Donovan, Dinh, Vance); Department of Health Care Policy, Harvard Medical School, Boston (Kessler, Zaslavsky, Sampson); Departments of Psychiatry and Family Medicine and Public Health, University of California, San Diego, and VA San Diego Healthcare System, San Diego (Stein).
Jazyk:	angličtina
Zdroj:	The American journal of psychiatry [Am J Psychiatry] 2021 Nov; Vol. 178 (11), pp. 1050-1059. Date of Electronic Publication: 2021 Sep 01.
DOI:	10.1176/appi.ajp.2021.20111570
Abstrakt:	Objective: The authors sought to identify predictors of imminent suicide attempt (within 30 days) among U.S. Army soldiers following their first documented suicidal ideation. Methods: Using administrative data from the Army Study to Assess Risk and Resilience in Servicemembers, the authors identified 11,178 active-duty Regular Army enlisted soldiers (2006-2009) with medically documented suicidal ideation and no prior medically documented suicide attempts. The authors examined risk factors for suicide attempt within 30 days of first suicidal ideation using logistic regression analyses, including sociodemographic and service-related characteristics, psychiatric diagnoses, physical health care visits, injuries, and history of family violence or crime perpetration or victimization. Results: Among soldiers with first documented suicidal ideation, 830 (7.4%) attempted suicide, 46.3% of whom (N=387) attempted suicide within 30 days (rate, 35.4 per 1,000 soldiers). Following a series of multivariate analyses, the final model identified females (odds ratio=1.3, 95% CI=1.0, 1.8), combat medics (odds ratio=1.6, 95% CI=1.1, 2.2), individuals with an anxiety disorder diagnosis prior to suicidal ideation (odds ratio=1.3, 95% CI=1.0, 1.6), and those who received a sleep disorder diagnosis on the same day as the recorded suicidal ideation (odds ratio=2.3, 95% CI=1.1, 4.6) as being more likely to attempt suicide within 30 days. Black soldiers (odds ratio=0.6, 95% CI=0.4, 0.9) and those who received an anxiety disorder diagnosis on the same day as suicidal ideation (odds ratio=0.7, 95% CI=0.5, 0.9) were less likely. Conclusions: Suicide attempt risk is highest in the first 30 days following ideation diagnosis and is more likely among women, combat medics, and soldiers with an anxiety disorder diagnosis before suicidal ideation and a same-day sleep disorder diagnosis. Black soldiers and those with a same-day anxiety disorder diagnosis were at decreased risk. These factors may help identify soldiers at imminent risk of suicide attempt.
Databáze:	MEDLINE
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