Operational Stress Injury Clinic, Parkwood Hospital, St Joseph's Health Care London, London, Ontario.
Can J Psychiatry. 2012 Aug;57(8):496-504. doi: 10.1177/070674371205700808.
Our study examines the association between suicidal ideation and and self-reported symptoms of posttraumatic stress disorder (PTSD), major depressive disorder (MDD), generalized anxiety disorder (GAD), and alcohol use disorder (AUD) in a sample of treatment-seeking Canadian combat and peacekeeping veterans; and identifies potential predictors of suicidal ideation.
Actively serving Canadian Forces and Royal Canadian Mounted Police members and veterans seeking treatment at the Parkwood Hospital Operational Stress Injury Clinic (n = 250) completed measures including the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire, the Alcohol Use Disorder Identification Test, and the PTSD Checklist-Military Version (PCL-M) between January 2002 and December 2010. Regression analyses were used to determine the respective impact of PTSD, and self-reported symptoms of MDD, GAD, AUD, and anxiety on suicidal ideation.
Most people met PCL-M screening criteria for PTSD (73.6%, n = 184), while 70.8% (n = 177) screened positively for a probable major depressive episode. PTSD symptom was significantly associated with suicidal ideation (β = 0.412, P < 0.001). After controlling for self-reported depressive symptom severity, AUD severity, and generalized anxiety, PTSD severity was no longer significantly associated with suicidal ideation (β = 0.043, P = 0.58).
Although PTSD alone is associated with suicidal ideation, after controlling for common comorbid psychiatric illnesses, self-reported depressive symptom severity emerged as the most significant predictor of suicidal ideation. These findings support the importance of screening for comorbidities, particularly an MDD, as potentially modifiable conditions that are strongly related to suicidal ideation in military personnel's endorsing criteria for PTSD.
本研究考察了在寻求治疗的加拿大战斗和维和退伍军人样本中，自杀意念与创伤后应激障碍（PTSD）、重度抑郁障碍（MDD）、广泛性焦虑障碍（GAD）和酒精使用障碍（AUD）自我报告症状之间的关联，并确定了自杀意念的潜在预测因素。
现役加拿大部队和加拿大皇家骑警成员以及在 Parkwood 医院作战应激损伤诊所寻求治疗的退伍军人（n = 250）在 2002 年 1 月至 2010 年 12 月期间完成了包括初级保健评估心理健康障碍患者健康问卷、酒精使用障碍识别测试和 PTSD 检查表-军事版本（PCL-M）在内的措施。回归分析用于确定 PTSD 以及自我报告的 MDD、GAD、AUD 和焦虑症状对自杀意念的各自影响。
大多数人符合 PTSD 的 PCL-M 筛查标准（73.6%，n = 184），而 70.8%（n = 177）筛查出可能的重度抑郁发作。PTSD 症状与自杀意念显著相关（β = 0.412，P < 0.001）。在控制了自我报告的抑郁症状严重程度、AUD 严重程度和广泛性焦虑后，PTSD 严重程度与自杀意念不再显著相关（β = 0.043，P = 0.58）。
尽管 PTSD 本身与自杀意念相关，但在控制了常见共病精神疾病后，自我报告的抑郁症状严重程度成为自杀意念的最显著预测因素。这些发现支持筛查共病的重要性，特别是 MDD，因为它们是与 PTSD 患者自杀意念密切相关的潜在可改变条件。
