Shelef L, Tomer G, Tatsa-Laur L, Kedem R, Bonne O, Fruchter E
Psychology Branch, Israeli Air Force, Ramat Gan, Israel; Mental Health Department, Medical Corps, Israel Defense Forces, Ramat Gan, Israel.
Military Track, The Hebrew University - Hadassah Medical School, Jerusalem, Israel.
Eur Psychiatry. 2017 Jan;39:106-113. doi: 10.1016/j.eurpsy.2016.08.005. Epub 2016 Dec 16.
Young age, availability of weapons, and stressful life events, increase the risk of suicide. The aim of the present study was to assess additional risk factors for suicide in the Israeli army.
We conducted a case-control study, to assess risk factors for suicide. The cases comprised soldiers who died by suicide during their military service (n=462; 0.039% of all soldiers in the cohort). The control group consisted of soldiers who did not commit suicide but were in active service during the investigated period (n=1,170,895; 99.96%). Predictor variables, including socio-demographic and psychiatric diagnoses, were considered.
Using a Generalized Linear Model with a Binary Logistic dependent variable to predict suicide, while controlling the effect of intervening variables, we found the following variables enhanced the risk for committing suicide: male (RR=6.703; P<0.001), country of origin: Ethiopia (RR=4.555; P=0.014), low socioeconomic status (RR=1.448; P=0.016) and low adjustment difficulties (RR=2.324; P<0.001). In addition, we found that in males only, Cluster B Personality Disorder (RR=2.548; P=0.027), low (RR=1.657; P=0.002), to average motivation to serve in a combat unit (RR=1.322; P=0.046) increased the risk for suicide.
IDF Soldiers bearing a psychiatric diagnosis or severe adjustment difficulties remained tightly monitored through their military service, and were found to be at a lower risk for suicide. However, those enlisted with mild (low) difficulties, were found to be at greater risk for suicide, as well as soldiers whose country of origin is Ethiopia. Suicide prevention program should focus on monitoring soldiers with these risk factors, together with soldiers' guidance regarding help seeking and de-stigmatizing suicide.
年轻、可获得武器以及生活压力事件会增加自杀风险。本研究的目的是评估以色列军队中自杀的其他风险因素。
我们进行了一项病例对照研究,以评估自杀的风险因素。病例包括在服兵役期间自杀死亡的士兵(n = 462;占队列中所有士兵的0.039%)。对照组由在调查期间未自杀但在现役的士兵组成(n = 1,170,895;99.96%)。考虑了预测变量,包括社会人口统计学和精神疾病诊断。
使用具有二元逻辑依赖变量的广义线性模型来预测自杀,同时控制干预变量的影响,我们发现以下变量会增加自杀风险:男性(相对风险[RR]=6.703;P<0.001)、原籍国:埃塞俄比亚(RR = 4.555;P = 0.014)、社会经济地位低(RR = 1.448;P = 0.016)和适应困难低(RR = 2.324;P<0.001)。此外,我们发现仅在男性中,B类人格障碍(RR = 2.548;P = 0.027)、低(RR = 1.657;P = 0.002)至中等在战斗部队服役的动机(RR = 1.322;P = 0.046)会增加自杀风险。
患有精神疾病诊断或严重适应困难的以色列国防军士兵在整个服役期间受到密切监测,发现其自杀风险较低。然而,那些有轻度(低)困难的入伍者以及原籍国为埃塞俄比亚的士兵被发现自杀风险更高。自杀预防计划应侧重于监测具有这些风险因素的士兵,以及为士兵提供有关寻求帮助和消除自杀污名化的指导。