Silvia Ronzitti1, Amy M Loree2, Marc N Potenza3, Suzanne E Decker4, Sarah M Wilson5, Erica A Abel4, Sally G Haskell4, Cynthia A Brandt4, Joseph L Goulet6. 1. VA Connecticut Healthcare System, West Haven, Connecticut; Yale School of Medicine, New Haven, Connecticut. Electronic address: silvia.ronzitti@yale.edu. 2. VA Connecticut Healthcare System, West Haven, Connecticut; Center for Health Policy & Health Services Research, Henry Ford Health System, Detroit, Michigan. 3. Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Department of Neuroscience, Child Study Center, Connecticut Mental Health Center, New Haven, Connecticut; Connecticut Council on Problem Gambling, Yale School of Medicine, New Haven, Connecticut. 4. VA Connecticut Healthcare System, West Haven, Connecticut. 5. VA Center for Health Services Research in Primary Care, Durham, North Carolina; Duke University School of Medicine, Durham, North Carolina; Durham Veterans Affairs Health Care System, Durham, North Carolina. 6. Pain Research, Informatics, Multimorbidities and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, Connecticut; Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut.
Abstract
BACKGROUND: Veterans have a high prevalence of both post-traumatic stress disorder (PTSD) and substance use disorders (SUDs), which are related to suicide risk. Exploring gender-related differences in suicidal behavior risk among this subgroup of veterans is important to improve prevention and treatment strategies. To date, few studies have explored these differences. METHODS: The sample included 352,476 men and women veterans from the Women Veterans Cohort Study with a diagnosis of PTSD. First, we conducted analyses to assess gender-related differences in sociodemographic and clinical variables at baseline, as well as by suicidal behavior. Then, we conducted a series of Cox proportional hazards regression models to estimate the hazard ratios of engaging in self-directed violence (SDV) and dying by suicide by SUD status and gender, controlling for potential confounders. RESULTS: Adjusted analyses showed that, among veterans with PTSD, the presence of a SUD significantly increased the risk of SDV and death by suicide. Women with PTSD had a decreased risk of dying by suicide compared with men. No gender-related difference was observed for SDV. SUD increased the risk of SDV behavior in both women and men but increased the risk of dying by suicide only among men. CONCLUSIONS: Our findings revealed gender-related differences in SDV and suicide among veterans with a PTSD diagnosis with or without a SUD. Our study, along with the increasing numbers of women serving in the military, stresses the need to conduct gender-based analyses to help improve prevention and treatment strategies. Published by Elsevier Inc.
BACKGROUND: Veterans have a high prevalence of both post-traumatic stress disorder (PTSD) and substance use disorders (SUDs), which are related to suicide risk. Exploring gender-related differences in suicidal behavior risk among this subgroup of veterans is important to improve prevention and treatment strategies. To date, few studies have explored these differences. METHODS: The sample included 352,476 men and women veterans from the Women Veterans Cohort Study with a diagnosis of PTSD. First, we conducted analyses to assess gender-related differences in sociodemographic and clinical variables at baseline, as well as by suicidal behavior. Then, we conducted a series of Cox proportional hazards regression models to estimate the hazard ratios of engaging in self-directed violence (SDV) and dying by suicide by SUD status and gender, controlling for potential confounders. RESULTS: Adjusted analyses showed that, among veterans with PTSD, the presence of a SUD significantly increased the risk of SDV and death by suicide. Women with PTSD had a decreased risk of dying by suicide compared with men. No gender-related difference was observed for SDV. SUD increased the risk of SDV behavior in both women and men but increased the risk of dying by suicide only among men. CONCLUSIONS: Our findings revealed gender-related differences in SDV and suicide among veterans with a PTSD diagnosis with or without a SUD. Our study, along with the increasing numbers of women serving in the military, stresses the need to conduct gender-based analyses to help improve prevention and treatment strategies. Published by Elsevier Inc.
Authors: Stephan Listabarth; Daniel König; Gabriela Berlakovich; Petra Munda; Peter Ferenci; Dagmar Kollmann; Georg Gyöeri; Thomas Waldhoer; Magdalena Groemer; Arjan van Enckevort; Benjamin Vyssoki Journal: J Clin Med Date: 2022-06-24 Impact factor: 4.964
Authors: Skye S Fitzpatrick; Antonio A Morgan-López; Tanya C Saraiya; Sudie E Back; Therese K Killeen; Sonya B Norman; Teresa López-Castro; Lesia M Ruglass; Lissette M Saavedra; Denise A Hien Journal: Psychol Addict Behav Date: 2021-06-17
Authors: Stephan Listabarth; Benjamin Vyssoki; Alexander Glahn; Andrea Gmeiner; Nathalie Pruckner; Sandra Vyssoki; Andreas Wippel; Thomas Waldhoer; Daniel König Journal: Eur Psychiatry Date: 2020-09-07 Impact factor: 5.361