US Department of Veterans Affairs, Post Deployment Health Services, Washington, DC, USA.
National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA.
Suicide Life Threat Behav. 2019 Jun;49(3):838-845. doi: 10.1111/sltb.12482. Epub 2018 Jun 21.
Research has demonstrated that posttraumatic stress disorder (PTSD) among Vietnam veterans is associated with increased risk of suicide. It is also widely reported that suicide is related to depression. This study examined the effect of PTSD and depression on risk of suicide among a cohort of Vietnam veterans.
All study subjects were selected from the Department of Veterans Affairs Agent Orange Registry. Suicide risk associated with PTSD was first assessed by comparing the number of suicides among a cohort of 2,874 veterans with PTSD to that of 8,537 veterans not diagnosed with PTSD. Risk of suicide was approximated by hazard ratios (HRs), generated by Cox proportional hazard models, including a model that utilized competing risk analyses.
The risk of suicide associated with PTSD and depression when examined separately was similar, HR = 7.1 (95% confidence interval (CI): 4.9, 10.3) and HR = 7.2 (95% CI: 4.8-10.8), respectively. Competing risk analysis indicated that veterans with both PTSD and depression compared to veterans with neither diagnosis had the highest risk of suicide, HR = 15.22.
This study suggests that depression as well as PTSD should be monitored as a way of reducing suicides among Vietnam veterans.
研究表明，越南退伍军人的创伤后应激障碍（PTSD）与自杀风险增加有关。广泛报道称，自杀与抑郁有关。本研究检查了 PTSD 和抑郁对一群越南退伍军人自杀风险的影响。
所有研究对象均选自退伍军人事务部橙剂登记处。首先通过比较 PTSD 队列中的 2874 名退伍军人与未诊断出 PTSD 的 8537 名退伍军人的自杀人数，评估 PTSD 相关的自杀风险。通过 Cox 比例风险模型生成风险比（HR）来近似自杀风险，该模型使用竞争风险分析。
单独检查 PTSD 和抑郁相关的自杀风险相似，HR=7.1（95%置信区间（CI）：4.9，10.3）和 HR=7.2（95% CI：4.8-10.8）。竞争风险分析表明，与既没有 PTSD 也没有抑郁诊断的退伍军人相比，同时患有 PTSD 和抑郁的退伍军人自杀风险最高，HR=15.22。
本研究表明，应监测抑郁和 PTSD，以降低越南退伍军人的自杀率。
