National Center for PTSD, Boston, MA, USA.
VA Boston Healthcare System, Boston, MA, USA.
Depress Anxiety. 2018 Jul;35(7):609-618. doi: 10.1002/da.22736. Epub 2018 Apr 10.
Suicide rates among veterans have increased markedly since the onset of Operations Enduring Freedom (OEF) and Iraqi Freedom (OIF; LeardMann et al., 2013). Identification of factors with the greatest contribution to suicide risk among veterans is needed to inform risk assessment and to identify intervention targets.
This study examined predictors of suicide attempts among participants in the Veterans After-Discharge Longitudinal Registry; a nationwide cohort of OEF/OIF veterans enrolled in Department of Veterans Affairs (VA) services. Veterans with and without probable posttraumatic stress disorder (PTSD) were sampled at a 3:1 ratio, and male and female veterans were sampled at a 1:1 ratio. Participants (N = 1,649) were assessed at two time points, roughly 2 years apart (M = 28.74 months, SD = 8.72).
Seventy-four participants (4.49%) attempted suicide during the follow-up period. The strongest predictors of suicide attempts among the full sample were suicidal intent, attempt history, suicide ideation, PTSD symptoms, alcohol use disorder (AUD) symptoms, and depression. Veterans with multiple risk factors were particularly vulnerable; of veterans with 0, ≥1, ≥2, ≥3, or ≥ 4 of these risk factors, 0%, 7.81%, 10.31%, 18.45%, and 20.51% made a suicide attempt, respectively.
This prospective study identified several strong predictors of suicide attempts among OEF/OIF veterans which may be important targets for suicide prevention efforts. Further, co-occurrence of multiple risk factors was associated with markedly greater risk for suicide attempts; veterans with multiple risk factors appear to be at the highest risk among OEF/OIF veterans enrolled in VA care.
自持久自由行动（OEF）和伊拉克自由行动（OIF；LeardMann 等人，2013）开始以来，退伍军人的自杀率显著增加。需要确定对退伍军人自杀风险贡献最大的因素，以便为风险评估提供信息，并确定干预目标。
本研究调查了退伍军人出院后纵向登记处参与者中自杀企图的预测因素；这是一个全国性的 OEF/OIF 退伍军人队列，在退伍军人事务部（VA）服务中注册。创伤后应激障碍（PTSD）可能性较高和较低的退伍军人以 3:1 的比例抽样，男女退伍军人以 1:1 的比例抽样。参与者（N=1649）在两个时间点进行评估，大致相隔 2 年（M=28.74 个月，SD=8.72）。
在随访期间，有 74 名参与者（4.49%）尝试自杀。全样本中自杀企图的最强预测因素是自杀意图、企图史、自杀意念、PTSD 症状、酒精使用障碍（AUD）症状和抑郁。有多种风险因素的退伍军人特别脆弱；在有 0、≥1、≥2、≥3 或≥4 个这些风险因素的退伍军人中，分别有 0%、7.81%、10.31%、18.45%和 20.51%尝试自杀。
这项前瞻性研究确定了 OEF/OIF 退伍军人自杀企图的几个重要预测因素，这些因素可能是预防自杀工作的重要目标。此外，多种风险因素的同时发生与自杀企图的风险显著增加相关；在接受 VA 护理的 OEF/OIF 退伍军人中，有多种风险因素的退伍军人似乎风险最高。
