Holliday Ryan, Borges Lauren M, Stearns-Yoder Kelly A, Hoffberg Adam S, Brenner Lisa A, Monteith Lindsey L
Rocky Mountain Mental Illness Research, Education and Clinical Center for Veteran Suicide Prevention, Aurora, CO, United States.
Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, United States.
Front Psychol. 2020 Aug 26;11:1998. doi: 10.3389/fpsyg.2020.01998. eCollection 2020.
Rates of suicide and posttraumatic stress disorder remain high among United States military personnel and veterans. Building upon prior work, we conducted a systematic review of research published from 2010 to 2018 regarding: (1) the prevalence of suicidal ideation, suicide attempt, and suicide among United States military personnel and veterans diagnosed with posttraumatic stress disorder; (2) whether posttraumatic stress disorder was associated with suicidal ideation, suicide attempt, and suicide among United States military personnel and veterans. 2,106 titles and abstracts were screened, with 48 articles included. Overall risk of bias was generally high for studies on suicidal ideation or suicide attempt and low for studies on suicide. Across studies, rates of suicidal ideation, suicide attempt, and suicide widely varied based on study methodology and assessment approaches. Findings regarding the association between posttraumatic stress disorder diagnosis with suicidal ideation and suicide were generally mixed, and some studies reported that posttraumatic stress disorder was associated with lower risk for suicide. In contrast, most studies reported significant associations between posttraumatic stress disorder and suicide attempt. These findings suggest complex associations between posttraumatic stress disorder and suicidal ideation, suicide attempt, and suicide, which are likely influenced by other factors (e.g., psychiatric comorbidity). In addition, most samples were comprised of veterans, rather than military personnel. Further research is warranted to elucidate associations between posttraumatic stress disorder and suicidal ideation, suicide attempt, and suicide, including identification of moderators and mediators of this relationship. Addressing this among United States military personnel, by gender, and in relation to different trauma types is also necessary.
在美国军事人员和退伍军人中，自杀率和创伤后应激障碍的发生率仍然很高。基于先前的研究成果，我们对2010年至2018年发表的研究进行了系统综述，内容涉及：（1）被诊断患有创伤后应激障碍的美国军事人员和退伍军人中自杀意念、自杀未遂和自杀的发生率；（2）创伤后应激障碍是否与美国军事人员和退伍军人中的自杀意念、自杀未遂和自杀有关。共筛选了2106篇标题和摘要，纳入了48篇文章。关于自杀意念或自杀未遂的研究，总体偏倚风险普遍较高；关于自杀的研究，总体偏倚风险较低。在各项研究中，根据研究方法和评估方法的不同，自杀意念、自杀未遂和自杀的发生率差异很大。关于创伤后应激障碍诊断与自杀意念和自杀之间关联的研究结果总体不一，一些研究报告称创伤后应激障碍与较低的自杀风险相关。相比之下，大多数研究报告创伤后应激障碍与自杀未遂之间存在显著关联。这些研究结果表明，创伤后应激障碍与自杀意念、自杀未遂和自杀之间存在复杂的关联，这可能受到其他因素（如精神疾病共病）的影响。此外，大多数样本由退伍军人组成，而非军事人员。有必要进行进一步的研究，以阐明创伤后应激障碍与自杀意念、自杀未遂和自杀之间的关联，包括确定这种关系的调节因素和中介因素。在美国军事人员中，按性别以及针对不同创伤类型进行研究也是必要的。
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