JAMA Psychiatry 2015[Sep]; 72 (9): 917-26 PMID26154106show ga
Importance: The U.S. Army suicide attempt rate increased sharply during the wars in Afghanistan and Iraq. Comprehensive research on this important health outcome has been hampered by a lack of integration among Army administrative data systems. Objective: To identify risk factors for Regular Army suicide attempts during the years 2004?2009 using data from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). Design, Setting, and Participants: There were 9,791 medically documented suicide attempts among Regular Army soldiers during the study period. Individual-level person-month records from Army and Department of Defense administrative data systems were analyzed to identify socio-demographic, service-related, and mental health risk factors distinguishing suicide attempt cases from an equal-probability control sample of 183,826 person-months. Main Outcome and Measures: Suicide attempts were identified using Department of Defense Suicide Event Report records and ICD-9 E95x diagnostic codes. Predictor variables were constructed from Army personnel and medical records. Results: Enlisted soldiers accounted for 98.6% of all suicide attempts, with an overall rate of 377/100,000 person-years, versus 27.9/100,000 person-years for officers. Significant multivariate predictors among enlisted soldiers included socio-demographic characteristics (female gender, older age at Army entry, younger current age, low education, non-hispanic white), short length of service, never or previously deployed, and the presence and recency of mental health diagnoses. Among officers, only socio-demographic characteristics (female gender, older age at Army entry, younger current age, and low education) and the presence and recency of mental health diagnoses were significant. Conclusions and Relevance: Results represent the most comprehensive accounting of U.S. Army suicide attempts to date and reveal unique risk profiles for enlisted soldiers and officers, and highlighting the importance of focusing research and prevention efforts on enlisted soldiers in their first tour of duty.
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JAMA+Psychiatry 2015 ; 72 (9): 917-26
