Am J Epidemiol. 2017 Sep 15;186(6):668-678. doi: 10.1093/aje/kwx117.
US enlisted Marines have experienced a substantial increase in suicide rates. We sought to identify risk factors for suicide completions among male Marines who entered basic training in San Diego, California, between June 2001 and October 2010. Suicides that occurred during active-duty military service were counted from June 1, 2001, through June 30, 2012. A total of 108,930 male Marines (66,286 deployers and 42,644 never deployed) were followed for 467,857 person-years of active-duty service time. Of the 790 deaths, 123 (15.6%) were suicides. In the final multivariate hazard model, preservice characteristics of not being a high-school graduate (hazard ratio (HR) = 2.17, 95% confidence interval (CI): 1.28, 3.68) and being a smoker at the time of enlistment (HR = 1.91, 95% CI: 1.32, 2.76) were significantly associated with a higher risk for suicide completion. Diagnosed with traumatic brain injury (HR = 4.09, 95% CI: 2.08, 8.05), diagnosed with depression (HR = 2.36, 95% CI: 1.22, 4.58), and received relationship counseling (HR = 3.71, 95% CI: 1.44, 9.54) during military service were significant risks for suicide death. Deployment alone was not significantly associated with a risk for suicide death (HR = 0.53, 95% CI: 0.26, 1.05).
美国应征入伍的海军陆战队员自杀率大幅上升。我们试图确定 2001 年 6 月至 2010 年 10 月在加利福尼亚州圣地亚哥接受基础训练的男性海军陆战队员自杀完成的风险因素。从 2001 年 6 月 1 日至 2012 年 6 月 30 日，现役期间发生的自杀事件均有记录。共有 108930 名男性海军陆战队员（66286 名部署人员和 42644 名从未部署人员）在 467857 人年的现役期间接受了随访。在 790 例死亡中，有 123 例（15.6%）为自杀。在最终的多变量风险模型中，未完成高中学业（风险比（HR）=2.17，95%置信区间（CI）：1.28，3.68）和入伍时吸烟（HR=1.91，95%CI：1.32，2.76）是与自杀完成风险较高相关的两个显著特征。诊断为创伤性脑损伤（HR=4.09，95%CI：2.08，8.05）、诊断为抑郁症（HR=2.36，95%CI：1.22，4.58）和在服役期间接受关系咨询（HR=3.71，95%CI：1.44，9.54）是自杀死亡的显著风险因素。仅部署本身与自杀死亡风险无显著相关性（HR=0.53，95%CI：0.26，1.05）。
