Lisham Ashrafioun1, Wilfred R Pigeon2, Kenneth R Conner2, Shirley H Leong3, David W Oslin3. 1. VISN 2 Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, USA; Department of Psychiatry, University of Rochester, School of Medicine & Dentistry, USA. Electronic address: Lisham.Ashrafioun@va.gov. 2. VISN 2 Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, USA; Department of Psychiatry, University of Rochester, School of Medicine & Dentistry, USA. 3. Department of Psychiatry, University of Pennsylvania, USA; VISN 4 Mental Illness, Research, Education and Clinical Center, Philadelphia VA Medical Center, USA.
Abstract
BACKGROUND: The Veterans Health Administration has made concerted efforts to increase mental health services offered in primary care. However, few studies have evaluated correlates of suicidal ideation and suicide attempt in veterans in primary care-mental health integration (PCMHI). The purpose of the present study is to examine associations between suicidal ideation and suicide attempts as dependent variables and demographic and clinical factors as the independent variables. METHODS: Veterans (n=3004) referred from primary care to PCMHI were contacted for further assessment, which included past-year severity of suicidal thoughts (none, low, high) and attempts using the Paykel Suicide Scale, mental health disorders, and illicit drug use. Multinomial logistic regression models were used to identify correlates of suicidal ideation and suicide attempts. RESULTS: Thoughts of taking one's life was endorsed by 24% of participants and suicide attempts were reported in 2%. In adjusted models, depression, psychosis, mania, PTSD and generalized anxiety disorder were associated with high severity suicidal ideation, but not suicide attempt. Illicit drug use was not associated with suicidal ideation, but was the only variable associated with suicide attempt. LIMITATIONS: The study was cross-sectional, focused on one clinical setting, and the suicide attempt analyses had limited power. CONCLUSIONS: PCMHI is a critical setting to assess suicidal ideation and suicide attempt and researchers and clinicians should be aware that the differential correlates of these suicide-related factors. Future research is needed to identify prospective risk factors and assess the utility of follow-up care in preventing suicide. Published by Elsevier B.V.
BACKGROUND: The Veterans Health Administration has made concerted efforts to increase mental health services offered in primary care. However, few studies have evaluated correlates of suicidal ideation and suicide attempt in veterans in primary care-mental health integration (PCMHI). The purpose of the present study is to examine associations between suicidal ideation and suicide attempts as dependent variables and demographic and clinical factors as the independent variables. METHODS: Veterans (n=3004) referred from primary care to PCMHI were contacted for further assessment, which included past-year severity of suicidal thoughts (none, low, high) and attempts using the Paykel Suicide Scale, mental health disorders, and illicit drug use. Multinomial logistic regression models were used to identify correlates of suicidal ideation and suicide attempts. RESULTS: Thoughts of taking one's life was endorsed by 24% of participants and suicide attempts were reported in 2%. In adjusted models, depression, psychosis, mania, PTSD and generalized anxiety disorder were associated with high severity suicidal ideation, but not suicide attempt. Illicit drug use was not associated with suicidal ideation, but was the only variable associated with suicide attempt. LIMITATIONS: The study was cross-sectional, focused on one clinical setting, and the suicide attempt analyses had limited power. CONCLUSIONS: PCMHI is a critical setting to assess suicidal ideation and suicide attempt and researchers and clinicians should be aware that the differential correlates of these suicide-related factors. Future research is needed to identify prospective risk factors and assess the utility of follow-up care in preventing suicide. Published by Elsevier B.V.
Authors: Angela M Bengtson; Brian W Pence; Katie R Mollan; Jessie K Edwards; Richard D Moore; Conall OʼCleirigh; Ellen F Eaton; Joseph J Eron; Mari M Kitahata; William C Mathews; Heidi Crane; Michael J Mugavero Journal: J Acquir Immune Defic Syndr Date: 2017-12-01 Impact factor: 3.731
Authors: Nathan A Kimbrel; Amie R Newins; Eric A Dedert; Elizabeth E Van Voorhees; Eric B Elbogen; Jennifer C Naylor; H Ryan Wagner; Mira Brancu; Jean C Beckham; Patrick S Calhoun Journal: J Psychiatr Res Date: 2017-01-05 Impact factor: 4.791
Authors: Angela M Bengtson; Brian W Pence; Ellen F Eaton; Jessie K Edwards; Joseph J Eron; William C Mathews; Katie Mollan; Richard D Moore; Connall O'Cleirigh; Elvin Geng; Michael J Mugavero Journal: Antivir Ther Date: 2018