King's Centre for Military Health Research, King's College London, London, United Kingdom.
Academic Department of Military Mental Health, King's College London, London, United Kingdom.
PLoS One. 2024 Apr 26;19(4):e0299239. doi: 10.1371/journal.pone.0299239. eCollection 2024.
Self-harm and suicide behaviours are a major public health concern. Several factors are associated with these behaviours among military communities. Identifying these factors may have important implications for policy and clinical services. The aim of this review was to identify the risk and protective factors associated with self-harm and suicide behaviours among serving and ex-serving personnel of the United Kingdom Armed Forces, Canadian Armed Forces, Australian Defence Force and New Zealand Defence Force.
A systematic search of seven online databases (PubMed, Web of Science, Embase, Global Health, PsycINFO, PTSDpubs and CINAHL) was conducted alongside cross-referencing, in October 2022. Following an a priori PROSPERO approved protocol (CRD42022348867), papers were independently screened and assessed for quality. Data were synthesised using a narrative approach.
Overall, 28 papers were included: 13 from Canada, 10 from the United Kingdom, five from Australia and none from New Zealand. Identified risk factors included being single/ex-relationship, early service leavers, shorter length of service (but not necessarily early service leavers), junior ranks, exposure to deployment-related traumatic events, physical and mental health diagnoses, and experience of childhood adversity. Protective factors included being married/in a relationship, higher educational attainment, employment, senior ranks, and higher levels of perceived social support.
Adequate care and support are a necessity for the military community. Prevention and intervention strategies for self-harm and suicide behaviours may be introduced early and may promote social networks as a key source of support. This review found a paucity of peer-reviewed research within some populations. More peer-reviewed research is needed, particularly among these populations where current work is limited, and regarding modifiable risk and protective factors.
自残和自杀行为是一个主要的公共卫生关注点。有几个因素与军事群体中的这些行为有关。识别这些因素可能对政策和临床服务具有重要意义。本综述的目的是确定与英国武装部队、加拿大武装部队、澳大利亚国防军和新西兰国防军现役和退伍军人的自残和自杀行为相关的风险和保护因素。
2022 年 10 月，我们对七个在线数据库（PubMed、Web of Science、Embase、Global Health、PsycINFO、PTSDpubs 和 CINAHL）进行了系统搜索，并进行了交叉引用。根据事先批准的 PROSPERO 协议（CRD42022348867），独立筛选和评估了论文的质量。使用叙述性方法综合数据。
总体而言，共纳入 28 篇论文：13 篇来自加拿大，10 篇来自英国，5 篇来自澳大利亚，没有来自新西兰的论文。确定的风险因素包括单身/离异、提前退伍、服役时间较短（但不一定是提前退伍）、初级军衔、接触与部署相关的创伤性事件、身体和心理健康诊断以及经历过童年逆境。保护因素包括已婚/有伴侣、较高的教育程度、就业、高级军衔以及更高水平的感知社会支持。
为军队社区提供充分的护理和支持是必要的。可能会尽早引入针对自残和自杀行为的预防和干预策略，并促进社交网络作为支持的主要来源。本综述发现，一些人群中缺乏同行评议的研究。需要更多的同行评议研究，特别是在当前工作有限的人群中，以及针对可改变的风险和保护因素。
