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Risk for suicidal behaviors associated with PTSD, depression, and their comorbidity in the U.S. Army.
J Affect Disord. 2014 Jun; 161:116-22.JA

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.

Authors+Show Affiliations

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.Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, United States.Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, United States.Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, United States.Harvard Medical School, Department of Health Care Policy, Boston, MA, United States.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.Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, United States.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24751318

Citation

Ramsawh, Holly J., et al. "Risk for Suicidal Behaviors Associated With PTSD, Depression, and Their Comorbidity in the U.S. Army." Journal of Affective Disorders, vol. 161, 2014, pp. 116-22.
Ramsawh HJ, Fullerton CS, Mash HB, et al. Risk for suicidal behaviors associated with PTSD, depression, and their comorbidity in the U.S. Army. J Affect Disord. 2014;161:116-22.
Ramsawh, H. J., Fullerton, C. S., Mash, H. B., Ng, T. H., Kessler, R. C., Stein, M. B., & Ursano, R. J. (2014). Risk for suicidal behaviors associated with PTSD, depression, and their comorbidity in the U.S. Army. Journal of Affective Disorders, 161, 116-22. https://doi.org/10.1016/j.jad.2014.03.016
Ramsawh HJ, et al. Risk for Suicidal Behaviors Associated With PTSD, Depression, and Their Comorbidity in the U.S. Army. J Affect Disord. 2014;161:116-22. PubMed PMID: 24751318.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk for suicidal behaviors associated with PTSD, depression, and their comorbidity in the U.S. Army. AU - Ramsawh,Holly J, AU - Fullerton,Carol S, AU - Mash,Holly B Herberman, AU - Ng,Tsz Hin H, AU - Kessler,Ronald C, AU - Stein,Murray B, AU - Ursano,Robert J, Y1 - 2014/03/25/ PY - 2014/02/25/received PY - 2014/03/07/accepted PY - 2014/4/23/entrez PY - 2014/4/23/pubmed PY - 2014/12/15/medline KW - Attempted KW - Depression KW - Military personnel KW - Post-traumatic KW - Stress disorders KW - Suicidal ideation SP - 116 EP - 22 JF - Journal of affective disorders JO - J Affect Disord VL - 161 N2 - 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. SN - 1573-2517 UR - https://www.unboundmedicine.com/medline/citation/24751318/Risk_for_suicidal_behaviors_associated_with_PTSD_depression_and_their_comorbidity_in_the_U_S__Army_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165-0327(14)00118-9 DB - PRIME DP - Unbound Medicine ER -