Holly J Ramsawh1, Carol S Fullerton2, Holly B Herberman Mash2, Tsz Hin H Ng2, Ronald C Kessler3, Murray B Stein4, Robert J Ursano2. 1. Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, United States. Electronic address: holly.ramsawh.ctr@usuhs.edu. 2. Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, United States. 3. Harvard Medical School, Department of Health Care Policy, Boston, MA, United States. 4. University of California, San Diego, Departments of Psychiatry & Family and Preventive Medicine, San Diego, CA, United States; Psychiatry Service, Veterans Affairs, San Diego Healthcare System, San Diego, CA, United States.
Abstract
BACKGROUND: Suicide rates have risen considerably in the United States Army in the past decade. Suicide risk is highest among those with past suicidality (suicidal ideation or attempts). The incidence of posttraumatic stress disorder (PTSD) and depressive illnesses has risen concurrently in the U.S. Army. We examined the relationship of PTSD and depression, independently and in combination, and rates of past-year suicidality in a representative sample of U.S. Army soldiers. METHODS: This study used the DoD Survey of Health Related Behaviors Among Active Duty Military Personnel (DoD HRB) (N=5927). Probable PTSD and depression were assessed with the PTSD Checklist (PCL) and the 10-item short form of the Center for Epidemiologic Studies Depression Scale (CES-D), respectively. Past-year suicidality was assessed via self-report. RESULTS: Six percent of Army service members reported suicidality within the past year. PTSD and MDD were each independently associated with past-year suicidality. Soldiers with both disorders were almost three times more likely to report suicidality within the past year than those with either diagnosis alone. Population-attributable risk proportions for PTSD, depression, and both disorders together were 24%, 29%, and 45%, respectively. LIMITATIONS: The current study is subject to the limitations of a cross-sectional survey design and the self-report nature of the instruments used. CONCLUSIONS: PTSD and depression are each associated with suicidality independently and in combination in the active duty component of the U.S. Army. Soldiers presenting with either but especially both disorders may require additional outreach and screening to decrease suicidal ideation and attempts.
BACKGROUND: Suicide rates have risen considerably in the United States Army in the past decade. Suicide risk is highest among those with past suicidality (suicidal ideation or attempts). The incidence of posttraumatic stress disorder (PTSD) and depressive illnesses has risen concurrently in the U.S. Army. We examined the relationship of PTSD and depression, independently and in combination, and rates of past-year suicidality in a representative sample of U.S. Army soldiers. METHODS: This study used the DoD Survey of Health Related Behaviors Among Active Duty Military Personnel (DoD HRB) (N=5927). Probable PTSD and depression were assessed with the PTSD Checklist (PCL) and the 10-item short form of the Center for Epidemiologic Studies Depression Scale (CES-D), respectively. Past-year suicidality was assessed via self-report. RESULTS: Six percent of Army service members reported suicidality within the past year. PTSD and MDD were each independently associated with past-year suicidality. Soldiers with both disorders were almost three times more likely to report suicidality within the past year than those with either diagnosis alone. Population-attributable risk proportions for PTSD, depression, and both disorders together were 24%, 29%, and 45%, respectively. LIMITATIONS: The current study is subject to the limitations of a cross-sectional survey design and the self-report nature of the instruments used. CONCLUSIONS:PTSD and depression are each associated with suicidality independently and in combination in the active duty component of the U.S. Army. Soldiers presenting with either but especially both disorders may require additional outreach and screening to decrease suicidal ideation and attempts.
Authors: Murray B Stein; Chia-Yen Chen; Robert J Ursano; Tianxi Cai; Joel Gelernter; Steven G Heeringa; Sonia Jain; Kevin P Jensen; Adam X Maihofer; Colter Mitchell; Caroline M Nievergelt; Matthew K Nock; Benjamin M Neale; Renato Polimanti; Stephan Ripke; Xiaoying Sun; Michael L Thomas; Qian Wang; Erin B Ware; Susan Borja; Ronald C Kessler; Jordan W Smoller Journal: JAMA Psychiatry Date: 2016-07-01 Impact factor: 21.596
Authors: Matthew K Nock; Robert J Ursano; Steven G Heeringa; Murray B Stein; Sonia Jain; Rema Raman; Xiaoying Sun; Wai Tat Chiu; Lisa J Colpe; Carol S Fullerton; Stephen E Gilman; Irving Hwang; James A Naifeh; Anthony J Rosellini; Nancy A Sampson; Michael Schoenbaum; Alan M Zaslavsky; Ronald C Kessler Journal: Suicide Life Threat Behav Date: 2015-01-26
Authors: Murray B Stein; Erin B Ware; Colter Mitchell; Chia-Yen Chen; Susan Borja; Tianxi Cai; Catherine L Dempsey; Carol S Fullerton; Joel Gelernter; Steven G Heeringa; Sonia Jain; Ronald C Kessler; James A Naifeh; Matthew K Nock; Stephan Ripke; Xiaoying Sun; Jean C Beckham; Nathan A Kimbrel; Robert J Ursano; Jordan W Smoller Journal: Am J Med Genet B Neuropsychiatr Genet Date: 2017-09-13 Impact factor: 3.568