Suicide Incidence and Risk Factors in an Active Duty US Military Population
ABSTRACT The goal of this study was to investigate and identify risk factors for suicide among all active duty members of the US military during 2005 or 2007.
The study used a cross-sectional design and included the entire active duty military population. Study sample sizes were 2,064,183 for 2005 and 1,981,810 for 2007. Logistic regression models were used.
Suicide rates for all services increased during this period. Mental health diagnoses, mental health visits, selective serotonin reuptake inhibitors (SSRIs), sleep prescriptions, reduction in rank, enlisted rank, and separation or divorce were associated with suicides. Deployments to Operation Enduring Freedom or Operation Iraqi Freedom were also associated with elevated odds ratios for all services in the 2007 population and for the Army in 2005.
Additional research needs to address the increasing rates of suicide in active duty personnel. This should include careful evaluation of suicide prevention programs and the possible increase in risk associated with SSRIs and other mental health drugs, as well as the possible impact of shorter deployments, age, mental health diagnoses, and relationship problems.
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ABSTRACT: Nature-assisted therapy (NAT) has become more common and recognized in both practice and research. The literature often describes how NAT gradually emerged in the UK and the US offering rehabilitation of soldiers suffering from traumatic experiences after active service in WW I and WW II. The main question of this review is to investigate what happened to this patient group? Consequently the aim is to systematically review: The literature; the evidence level; the health outcomes; and the transmissibility of the therapy programmes and results for practitioners. The review describes the development and status of practice and research concerning NAT for veterans with post-traumatic stress disorder (PTSD). The systematic review included a seven-step literature search. Relevant data sources were scrutinized in order to retrieve literature meeting the predefined inclusion criteria. Due to the limited amount of peer-reviewed literature, non-peer-reviewed literature was also included in the review. The final selection yielded eleven peer reviewed and nine non-peer-reviewed publications. Three can be characterized as RCT studies, while the remainder is qualitative case studies. Eight themes emerged from the systematic analysis of the qualitative case studies. This review found that a large amount of projects offering NAT to veterans suffering from PTSD exist in many parts of the world and they present no adverse negative results. Recommendations for future practice and research are posed.Urban Forestry & Urban Greening 04/2015; 14(2):438-445. DOI:10.1016/j.ufug.2015.03.009 · 2.13 Impact Factor
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ABSTRACT: A meta-analysis of 25 epidemiological studies estimated the prevalence of recent Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) major depression (MD) among U.S. military personnel. Best estimates of recent prevalence (standard error) were 12.0% (1.2) among currently deployed, 13.1% (1.8) among previously deployed, and 5.7% (1.2) among never deployed. Consistent correlates of prevalence were being female, enlisted, young (ages 17-25), unmarried, and having less than a college education. Simulation of data from a national general population survey was used to estimate expected lifetime prevalence of MD among respondents with the sociodemographic profile and none of the enlistment exclusions of Army personnel. In this Simulated sample, 16.2% (3.1) of respondents had lifetime MD and 69.7% (8.5) of first onsets occurred before expected age of enlistment. Numerous methodological problems limit the results of the meta-analysis and simulation. The article closes with a discussion of recommendations for correcting these problems in future surveillance and operational stress studies.Military medicine 08/2012; 177(8 Suppl):47-59. DOI:10.7205/MILMED-D-12-00103 · 0.77 Impact Factor
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ABSTRACT: Limited data are available on lifetime prevalence and age-of-onset distributions of psychological disorders and suicidal behaviors among Army personnel. We used simulation methods to approximate such estimates based on analysis of data from a U.S. national general population survey with the sociodemographic profile of U.S. Army personnel. Estimated lifetime prevalence of any Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) anxiety, mood, behavior, or substance disorder in this sample was 53.1% (17.7% for mood disorders, 27.2% for anxiety disorders, 22.7% for behavior disorders, and 14.4% for substance disorders). The vast majority of cases had onsets before the expected age of enlistment if they were in the Army (91.6%). Lifetime prevalence was 14.2% for suicidal ideation, 5.4% for suicide plans, and 4.5% for suicide attempts. The proportion of estimated preenlistment onsets was between 68.4% (suicide plans) and 82.4% (suicidal ideation). Externalizing disorders with onsets before expected age of enlistment and internalizing disorders with onsets after expected age of enlistment significantly predicted postenlistment suicide attempts, with population attributable risk proportions of 41.8% and 38.8%, respectively. Implications of these findings are discussed for interventions designed to screen, detect, and treat psychological disorders and suicidality in the Army.Military medicine 09/2012; 177(9):1002-10. DOI:10.7205/MILMED-D-12-00092 · 0.77 Impact Factor