The Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
J Affect Disord. 2011 Apr;130(1-2):231-8. doi: 10.1016/j.jad.2010.10.021. Epub 2010 Nov 4.
The purpose of this project was to examine factors associated with suicidal ideation in returning Iraq and Afghanistan war veterans.
A cross-sectional review of 1740 veterans' initial mental health screening evaluations. One-hundred and thirteen (6.5%) OEF/OIF veterans reported active suicidal ideation at the time of the interview.
Prior exposures of physical or sexual abuse and having a history of a prior suicide attempt(s) were associated with the presence of current suicidal ideation, as were having a diagnosis of a psychotic disorder, a depressive disorder, or posttraumatic stress disorder (PTSD). Deployment concerns related to training (protective), the deployment environment, family concerns, deployment concerns, post-deployment support (protective), and post-deployment stressors were also associated with current suicidal ideation. Logistic regression analysis revealed the major risk factors were having a prior suicide attempt, female gender, and a depressive disorder diagnosis; while more perceived current social support was a protective factor. Logistic regression analysis also revealed having comorbid PTSD and depression carried a higher odds ratio for risk than did having either PTSD or depression alone; and that the PTSD avoidance symptom-cluster was associated with more risk than either the re-experiencing or hyper-arousal symptom clusters for current suicidal ideation.
As a cross-sectional retrospective medical chart review, limitations include limited generalizability and causal relationships cannot be evaluated.
Further investigation of these risk factors is warranted to aid in suicide risk assessment and in the development of targeted interventions to mitigate the identified risk factors and bolster the identified protective factor.
本研究旨在探讨与归国的伊拉克和阿富汗战争退伍军人自杀意念相关的因素。
对 1740 名退伍军人初始心理健康筛查评估进行横断面回顾。在访谈时，有 113 名（6.5%）OEF/OIF 退伍军人报告存在活跃的自杀意念。
先前经历过身体或性虐待以及有自杀未遂史与当前自杀意念的存在相关，此外，还存在精神障碍、抑郁障碍或创伤后应激障碍（PTSD）的诊断。与培训（保护）、部署环境、家庭问题、部署相关问题、部署后支持（保护）和部署后压力源相关的部署问题也与当前自杀意念相关。逻辑回归分析显示，主要风险因素是有自杀未遂史、女性性别和抑郁障碍诊断；而更多的感知到当前社会支持是一个保护因素。逻辑回归分析还表明，同时患有 PTSD 和抑郁障碍比仅患有 PTSD 或抑郁障碍的风险更高；并且 PTSD 回避症状群比再体验或过度唤醒症状群与当前自杀意念的风险更高相关。
由于这是一项横断面回顾性病历回顾研究，存在一定的局限性，包括可推广性有限，无法评估因果关系。
有必要进一步研究这些风险因素，以帮助进行自杀风险评估，并制定有针对性的干预措施，以减轻已确定的风险因素并加强已确定的保护因素。
