Differences Between Veteran Suicides With and Without Psychiatric Symptoms

ArticleinAmerican Journal of Public Health 102 Suppl 1(S1):S125-30 · March 2012with5 Reads
DOI: 10.2105/AJPH.2011.300415 · Source: PubMed
Abstract
Our objective was to examine all suicides (n = 423) in 2 geographic areas of the Veterans Health Administration (VHA) over a 7-year period and to perform detailed chart reviews on the subsample that had a VHA visit in the last year of life (n = 381). Within this sample, we compared a group with 1 or more documented psychiatric symptoms (68.5%) to a group with no such symptoms (31.5%). The groups were compared on suicidal thoughts and behaviors, somatic symptoms, and stressors using the χ(2) test and on time to death after the last visit using survival analyses. Veterans with documented psychiatric symptoms were more likely to receive a suicide risk assessment, and have suicidal ideation and a suicide plan, sleep problems, pain, and several stressors. These veterans were also more likely to die in the 60 days after their last visit. Findings indicated presence of 2 large and distinct groups of veterans at risk for suicide in the VHA, underscoring the value of tailored prevention strategies, including approaches suitable for those without identified psychiatric symptoms.
    • "Veterans, particularly those who have been in proximity to combat, are at risk of developing severe and/or persistent psychosocial health problems as a direct or indirect result of their military experience (see Friedman, 2006; Knudsen & Wingenfeld, 2015). Many veterans endure cumulative disadvantages of mental health issues (Britton et al., 2012; Tanielian et al., 2008; Tsai, Rosenheck, Kasprow, & McGuire, 2013), combat-related trauma (Holcomb et al., 2007 ), and substance use/abuse (Jacobson et al., 2008). These risks factors increase veterans' likelihood of coming into contact with the criminal justice system (Blodgett, Fuh, Maisel, & Midboe, 2013; see also Shen, Arkes, & Williams, 2012). "
    Full-text · Article · Dec 2015
  • Article · Mar 2012
  • [Show abstract] [Hide abstract] ABSTRACT: We examined the role of sleep disturbance in time to suicide since the last treatment visit among veterans receiving Veterans Health Administration (VHA) services. Among 423 veteran suicide decedents from 2 geographic areas, systematic chart reviews were conducted on the 381 (90.1%) who had a VHA visit in the last year of life. Veteran suicides with a documented sleep disturbance (45.4%) were compared with those without sleep disturbance (54.6%) on time to death since their last VHA visit using an accelerated failure time model. Veterans with sleep disturbance died sooner after their last visit than did those without sleep disturbance, after we adjusted for the presence of mental health or substance use symptoms, age, and region. Findings indicated that sleep disturbance was associated with time to suicide in this sample of veterans who died by suicide. The findings had implications for using the presence of sleep disturbance to detect near-term risk for suicide and suggested that sleep disturbance might provide an important intervention target for a subgroup of at-risk veterans.
    Article · Mar 2012
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