Denneson Lauren M, Kovas Anne E, Britton Peter C, Kaplan Mark S, McFarland Bentson H, Dobscha Steven K
Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System, Portland, OR, USA.
Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA.
Suicide Life Threat Behav. 2016 Jun;46(3):363-74. doi: 10.1111/sltb.12226. Epub 2016 Feb 1.
A total of 295 veterans who died by suicide in 2009 across 11 states and received Veterans Affairs (VA) health care in the 6 months prior to death were identified. The suicide risk factors documented and the care received at these veterans' last VA contacts are described, and the study explores whether veterans present differently to VA care (i.e., different risk factors documented or different care settings accessed) based on the proximity of their last contact to suicide. Many veterans were seen in primary care (n = 136; 46%) for routine follow-up (n = 168; 57%). Fifty-three (18%) were assessed for suicidal thoughts; 20 (38%) of whom endorsed such thoughts. Although higher frequencies of some risk factors at last contacts more proximal to suicide compared to those more distal were observed, findings overall highlight the challenges clinicians face detecting enhanced risk prior to suicide.
研究确定了2009年在11个州自杀身亡且在死亡前6个月接受过退伍军人事务部(VA)医疗保健服务的295名退伍军人。本文描述了这些退伍军人记录在案的自杀风险因素以及他们最后一次与VA接触时接受的治疗,并探讨退伍军人根据其最后一次接触到自杀的时间间隔,在接受VA治疗时是否表现不同(即记录的风险因素不同或就诊的医疗机构不同)。许多退伍军人因常规随访(n = 168;57%)而接受初级保健(n = 136;46%)。53人(18%)接受了自杀念头评估;其中20人(38%)认可有此类念头。尽管观察到与自杀时间间隔较远的最后一次接触相比,更接近自杀的最后一次接触中某些风险因素的出现频率更高,但总体研究结果凸显了临床医生在自杀前发现风险增加时所面临的挑战。