King's Centre for Military Health Research, King's College London, UK.
Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre, Stanford Hall Estate, Nottinghamshire, UK.
Int J Soc Psychiatry. 2024 Nov;70(7):1279-1288. doi: 10.1177/00207640241264195. Epub 2024 Jul 31.
BACKGROUND/AIMS: Suicidal Ideation (SI) is a risk factor for suicide, a leading cause of death amongst young men globally. In this study we assess whether sustaining a serious physical combat injury is associated with SI and whether leaving service mediates this association.
We analysed data from male UK Armed Forces personnel who sustained a combat injury in Afghanistan and a frequency-matched comparison group who did not sustain such an injury (the ADVANCE cohort). SI was measured from the Patient Health Questionnaire-9 item 'thoughts that you would be better off dead or of hurting yourself in some way'.
Approximately, 11.9% ( = 61) of the uninjured group, 15.3% ( = 83) of the overall injured group, 8.5% ( = 13) of an Amputation injury (AI) subgroup and 17.6% ( = 70) of a Non-Amputation Injury (NAI) subgroup reported SI in the past 2 weeks. The NAI subgroup reported greater likelihood of SI (Relative Risk Ratio (RR) = 1.44, 95% confidence interval (CI) [1.04, 2.00]) compared to the comparison group, whereas the overall injured group (RR = 1.23, 95% CI [0.90, 1.68]) and AI subgroup (RR = 0.65, 95% CI [0.36, 1.18]) did not. Leaving service fully mediated the association between sustaining a NAI and SI (natural direct effect RR = 1.08, 95% CI [0.69, 1.69]).
UK military personnel with NAI reported significantly higher rates of SI compared to demographically similar uninjured personnel, while those who sustained AIs reported no significant difference. Leaving service was associated with greater rates of SI for both injured and uninjured personnel and fully mediated the association between sustaining a NAI and SI.
背景/目的：自杀意念（SI）是自杀的一个风险因素，也是全球年轻男性死亡的主要原因。在这项研究中，我们评估了是否持续遭受严重的身体战斗伤害与 SI 有关，以及退伍是否会调解这种关联。
我们分析了在阿富汗遭受战斗伤害的英国武装部队男性人员和未遭受此类伤害的频率匹配对照组（ADVANCE 队列）的数据。SI 通过患者健康问卷-9 项“有过想死或伤害自己的想法”来衡量。
大约 11.9%（=61）的未受伤组、15.3%（=83）的总体受伤组、8.5%（=13）的截肢伤（AI）亚组和 17.6%（=70）的非截肢伤（NAI）亚组在过去 2 周内报告有 SI。与对照组相比，NAI 亚组报告的 SI 可能性更高（相对风险比（RR）=1.44，95%置信区间（CI）[1.04，2.00]），而总体受伤组（RR=1.23，95%CI [0.90，1.68]）和 AI 亚组（RR=0.65，95%CI [0.36，1.18]）则没有。完全退伍完全调解了 NAI 与 SI 之间的关联（自然直接效应 RR=1.08，95%CI [0.69，1.69]）。
与人口统计学相似的未受伤人员相比，英国军人中报告有 NAI 的人员 SI 发生率明显更高，而报告有 AI 的人员则没有明显差异。退伍与受伤和未受伤人员的 SI 发生率较高有关，并完全调解了 NAI 与 SI 之间的关联。
