Vedtofte Mia S, Elrond Andreas F, Erlangsen Annette, Nielsen Anni B S, Stoltenberg Christian D G, Marott Jacob L, Nissen Lars R, Madsen Trine
Research and Knowledge Centre, the Danish Veteran Centre, Ringsted, Denmark.
Corresponding author: Mia Sadowa Vedtofte, PhD, Research and Knowledge Centre, The Danish Veterans Centre, Garnisonen 1, 4100 Ringsted, Denmark (
J Clin Psychiatry. 2021 Oct 12;82(6):20m13251. doi: 10.4088/JCP.20m13251.
The aim of this study was to estimate the association between self-reported perceived danger during deployment, measured as combat exposure or witnessing the consequences of war, and post-deployment suicide attempts among military personnel. Furthermore, the effect of post-deployment symptoms of posttraumatic stress disorder (PTSD) and/or depression on the risk of suicide attempts was also evaluated. This observational cohort study included Danish Army military personnel who returned from deployment in international missions from 1998 to 2016 and had completed a post-deployment questionnaire. Perceived exposure to danger was ascertained by self-report. Data on suicide attempt were retrieved from national registers. Adjusted Cox regression analyses were used to evaluate if military personnel indicating high level of combat exposure were more likely to have attempted suicides post-deployment than military personnel with lower levels of combat exposure. Eighty-three suicide attempts were registered after homecoming among 12,218 military personnel. Perceived higher exposure to combat was associated with the risk of suicide attempt (hazard ratio = 1.08; 95% CI, 1.01-1.16). Furthermore, the association between combat exposure and suicide attempt was fully mediated by post-deployment symptoms of PTSD and/or depression. No association was found between witnessing consequences of war and the risk of post-deployment suicide attempt. This nationwide study found that combat exposure was associated with an increased risk of suicide attempt among military personnel. This association was, however, fully mediated by mental disorders (PTSD and/or depression). These findings suggest that better psychological follow-up of military personnel identified as having PTSD and/or depression may be warranted.
本研究的目的是评估部署期间自我报告的感知危险（以战斗暴露或目睹战争后果衡量）与军事人员部署后自杀未遂之间的关联。此外，还评估了创伤后应激障碍（PTSD）和/或抑郁症的部署后症状对自杀未遂风险的影响。这项观察性队列研究纳入了1998年至2016年从国际任务部署中返回并完成部署后调查问卷的丹麦陆军军事人员。感知到的危险暴露通过自我报告确定。自杀未遂数据从国家登记册中获取。采用校正后的Cox回归分析来评估表明战斗暴露水平高的军事人员在部署后自杀未遂的可能性是否高于战斗暴露水平低的军事人员。在12,218名军事人员回国后记录到83起自杀未遂事件。感知到更高的战斗暴露与自杀未遂风险相关（风险比=1.08；95%CI，1.01-1.16）。此外，战斗暴露与自杀未遂之间的关联完全由PTSD和/或抑郁症的部署后症状介导。未发现目睹战争后果与部署后自杀未遂风险之间存在关联。这项全国性研究发现，战斗暴露与军事人员自杀未遂风险增加相关。然而，这种关联完全由精神障碍（PTSD和/或抑郁症）介导。这些发现表明，可能有必要对被确定患有PTSD和/或抑郁症的军事人员进行更好的心理随访。
