Kimerling Rachel, Makin-Byrd Kerry, Louzon Samantha, Ignacio Rosalinda V, McCarthy John F
National Center for PTSD, VA Palo Alto Health Care System, Menlo Park, California; Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, California; National MST Support Team, VA Mental Health Services, Department of Veterans Affairs, Menlo Park, California.
National Center for PTSD, VA Palo Alto Health Care System, Menlo Park, California; National MST Support Team, VA Mental Health Services, Department of Veterans Affairs, Menlo Park, California.
Am J Prev Med. 2016 Jun;50(6):684-691. doi: 10.1016/j.amepre.2015.10.019. Epub 2015 Dec 14.
The Veterans Health Administration health system uses a clinical reminder in the medical record to screen for military sexual trauma. For more than 6 million Veterans, this study assessed associations between military sexual trauma screen results and subsequent suicide mortality.
For Veterans who received Veterans Health Administration services in fiscal years 2007-2011 and were screened for military sexual trauma (5,991,080 men; 360,774 women), proportional hazards regressions evaluated associations between military sexually trauma and suicide risk. Models were adjusted for age, rural residence, medical morbidity, and psychiatric conditions, obtained from medical records at the year military sexual trauma screening occurred. Analyses were conducted in 2014.
Military sexual trauma was reported by 1.1% of men and 21.2% of women. A total of 9,017 Veterans completed suicide during the follow-up period. Hazard ratios for military sexual trauma were 1.69 (95% CI=1.45, 1.97) among men and 2.27 (95% CI=1.76, 2.94) among women. Suicide risk associated with military sexual trauma remained significantly elevated in adjusted models.
Study results are among the first population-based investigations to document sexual trauma as a risk factor for suicide mortality. Military sexual trauma represents a clinical indicator for suicide prevention in the Veterans Health Administration. Results suggest the importance of continued assessments regarding military sexual trauma and suicide risks and of collaboration between military sexual trauma-related programs and suicide prevention efforts. Moreover, military sexual trauma should be considered in suicide prevention strategies even among individuals without documented psychiatric morbidity.
退伍军人健康管理局医疗系统利用病历中的临床提醒来筛查军事性创伤。本研究针对600多万退伍军人，评估了军事性创伤筛查结果与随后自杀死亡率之间的关联。
对于在2007 - 2011财年接受退伍军人健康管理局服务并接受军事性创伤筛查的退伍军人（5991080名男性；360774名女性），比例风险回归评估了军事性创伤与自杀风险之间的关联。模型根据军事性创伤筛查当年病历中获取的年龄、农村居住情况、医疗发病率和精神疾病状况进行了调整。分析于2014年进行。
1.1%的男性和21.2%的女性报告有军事性创伤。在随访期间，共有9017名退伍军人自杀。男性中军事性创伤的风险比为1.69（95%置信区间 = 1.45, 1.97），女性中为2.27（95%置信区间 = 1.76, 2.94）。在调整后的模型中，与军事性创伤相关的自杀风险仍然显著升高。
研究结果是首批基于人群的调查之一，将性创伤记录为自杀死亡率的一个风险因素。军事性创伤是退伍军人健康管理局自杀预防的一个临床指标。结果表明持续评估军事性创伤和自杀风险以及军事性创伤相关项目与自杀预防工作之间合作的重要性。此外，即使在没有记录精神疾病的个体中，自杀预防策略也应考虑军事性创伤因素。
