文章基本信息

标题：Suicide Incidence and Risk Factors in an Active Duty US Military Population
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作者：Jeffrey Hyman ; Robert Ireland ; Lucinda Frost 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2012
卷号：102
期号：Suppl 1
页码：S138-S146
DOI：10.2105/AJPH.2011.300484
语种：English
出版社：American Public Health Association
摘要：Objectives. 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. Methods. 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. Results. 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. Conclusions. 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. The rate of suicide among those serving in the military has been an increasing focus of concern for the respective Military Departments, Members of Congress, and Department of Defense (DoD) senior leadership. This has been of special concern for the US Army because their rate of completed suicides has markedly increased since 2006. 1 There has been a concerted effort by each Military Department to implement suicide prevention initiatives, especially those targeting early identification of manifest risk factors that may indicate a need for treatment. Self-recognition of indicators of distress and a willingness to seek help have also been emphasized. The Air Force Suicide Prevention program is an example. Initiated in the late 1990s, it is now listed as a best practice by the Centers for Disease Control. 2 This study was initiated by the Secretary of the Army to examine potential risk factors associated with completed suicides. The goal was to determine what caused the marked increase in the rate of suicides in the Army between 2005 and 2007. The initial study population included the Marine Corp as a comparison population for the active duty Army. At the request of the Office of the Assistant Secretary of Defense for Health Affairs and the DoD Suicide Prevention and Risk Reduction Committee (SPARRC), the original study was expanded to include active duty Air Force and Navy personnel. Before 2008, risk factor analyses for DoD completed suicides were performed for relatively small populations, primarily at the Military Department level using service-unique databases. Each department used a different data collection tool and information system. This made it extremely difficult to electronically merge the data for comparison or aggregate reporting. Available department level data were also subject to the statistical limitations that were associated with smaller populations and relatively rare events. This study was the first to combine DoD standardized suicide data, DoD-wide personnel data including deployments and marital status, and DoD-wide medical data with diagnoses and medical treatments. The goal of this study was to use all available quantitative data to investigate a wide range of potential risk factors that might be associated with suicides and the increase of suicides among active duty military personnel.