Department of Psychiatry, University of Maryland School of Medicine.
Psychol Serv. 2018 Feb;15(1):31-39. doi: 10.1037/ser0000127. Epub 2017 Mar 13.
Individuals with serious mental illness and veterans are two populations at elevated risk for suicide; however, research has not examined whether veterans with serious mental illness may be at higher suicide risk than nonveterans with serious mental illness. Additionally, overlapping risk factors for suicide in these populations may account for differences in suicide-related outcomes between these groups. Therefore, the aim of this study was to identify differences in death ideation and suicide ideation among veterans and nonveterans with serious mental illness. We also aimed to explore these effects after adjusting for potentially shared risk factors. We found that veterans with serious mental illness reported death ideation and suicide ideation more than twice as often as nonveterans with serious mental illness. After adjusting for demographic, psychiatric, and theory-driven risk factors, the effect of veteran status on death ideation remained significant, though the effect on suicide ideation was no longer significant. Depressive and psychotic symptoms were significant predictors of death ideation; depressive symptoms and hostility were significant predictors of suicide ideation. Clinicians should particularly monitor death ideation and suicide ideation in veterans with serious mental illness, as well as associated clinical risk factors such as depression, psychotic symptoms, and hostility. (PsycINFO Database Record
个体患有严重精神疾病和退伍军人是自杀风险较高的两个群体；然而，研究尚未探讨患有严重精神疾病的退伍军人的自杀风险是否高于患有严重精神疾病的非退伍军人。此外，这些人群中自杀的重叠风险因素可能解释了这些群体之间与自杀相关结局的差异。因此，本研究的目的是确定患有严重精神疾病的退伍军人和非退伍军人之间的死亡意念和自杀意念差异。我们还旨在探讨在调整潜在共享风险因素后这些效果的变化。我们发现，患有严重精神疾病的退伍军人报告死亡意念和自杀意念的频率是患有严重精神疾病的非退伍军人的两倍多。在调整人口统计学、精神科和基于理论的风险因素后，退伍军人身份对死亡意念的影响仍然显著，尽管对自杀意念的影响不再显著。抑郁和精神病症状是死亡意念的重要预测因素；抑郁症状和敌意是自杀意念的重要预测因素。临床医生应特别监测患有严重精神疾病的退伍军人的死亡意念和自杀意念，以及相关的临床风险因素，如抑郁、精神病症状和敌意。
