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Prevalence and correlates of suicidal ideation and suicide attempts among veterans in primary care referred for a mental health evaluation.
J Affect Disord. 2016 Jan 01; 189:344-50.JA

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.

Authors+Show Affiliations

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.VISN 2 Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, USA; Department of Psychiatry, University of Rochester, School of Medicine & Dentistry, USA.VISN 2 Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, USA; Department of Psychiatry, University of Rochester, School of Medicine & Dentistry, USA.Department of Psychiatry, University of Pennsylvania, USA; VISN 4 Mental Illness, Research, Education and Clinical Center, Philadelphia VA Medical Center, USA.Department of Psychiatry, University of Pennsylvania, USA; VISN 4 Mental Illness, Research, Education and Clinical Center, Philadelphia VA Medical Center, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26474375

Citation

Ashrafioun, Lisham, et al. "Prevalence and Correlates of Suicidal Ideation and Suicide Attempts Among Veterans in Primary Care Referred for a Mental Health Evaluation." Journal of Affective Disorders, vol. 189, 2016, pp. 344-50.
Ashrafioun L, Pigeon WR, Conner KR, et al. Prevalence and correlates of suicidal ideation and suicide attempts among veterans in primary care referred for a mental health evaluation. J Affect Disord. 2016;189:344-50.
Ashrafioun, L., Pigeon, W. R., Conner, K. R., Leong, S. H., & Oslin, D. W. (2016). Prevalence and correlates of suicidal ideation and suicide attempts among veterans in primary care referred for a mental health evaluation. Journal of Affective Disorders, 189, 344-50. https://doi.org/10.1016/j.jad.2015.09.014
Ashrafioun L, et al. Prevalence and Correlates of Suicidal Ideation and Suicide Attempts Among Veterans in Primary Care Referred for a Mental Health Evaluation. J Affect Disord. 2016 Jan 1;189:344-50. PubMed PMID: 26474375.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence and correlates of suicidal ideation and suicide attempts among veterans in primary care referred for a mental health evaluation. AU - Ashrafioun,Lisham, AU - Pigeon,Wilfred R, AU - Conner,Kenneth R, AU - Leong,Shirley H, AU - Oslin,David W, Y1 - 2015/09/28/ PY - 2015/04/23/received PY - 2015/08/24/revised PY - 2015/09/05/accepted PY - 2015/10/17/entrez PY - 2015/10/17/pubmed PY - 2016/6/18/medline KW - Primary care KW - Suicidal ideation KW - Suicide attempt KW - Veterans SP - 344 EP - 50 JF - Journal of affective disorders JO - J Affect Disord VL - 189 N2 - 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. SN - 1573-2517 UR - https://www.unboundmedicine.com/medline/citation/26474375/Prevalence_and_correlates_of_suicidal_ideation_and_suicide_attempts_among_veterans_in_primary_care_referred_for_a_mental_health_evaluation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165-0327(15)30126-9 DB - PRIME DP - Unbound Medicine ER -