Format

Send to

Choose Destination
JAMA Netw Open. 2020 Jan 3;3(1):e1919935. doi: 10.1001/jamanetworkopen.2019.19935.

Factors Associated With Suicide Ideation in US Army Soldiers During Deployment in Afghanistan.

Author information

1
Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
2
Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts.
3
Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
4
Institute for Social Research, University of Michigan, Ann Arbor.
5
Department of Psychology, Harvard University, Cambridge, Massachusetts.
6
Department of Psychiatry, University of California, San Diego, La Jolla.
7
Department of Family and Preventive Medicine, University of California, San Diego, La Jolla.
8
VA San Diego Healthcare System, La Jolla, California.

Abstract

Importance:

Understanding suicide ideation (SI) during combat deployment can inform prevention and treatment during and after deployment.

Objective:

To examine associations of sociodemographic characteristics, lifetime and past-year stressors, and mental disorders with 30-day SI among a representative sample of US Army soldiers deployed in Afghanistan.

Design, Setting, and Participants:

In this survey study, soldiers deployed to Afghanistan completed self-administered questionnaires in July 2012. The sample was weighted to represent all 87 032 soldiers serving in Afghanistan. Prevalence of lifetime, past-year, and 30-day SI and mental disorders was determined. Logistic regression analyses examined risk factors associated with SI. Data analyses for this study were conducted between August 2018 and August 2019.

Main Outcomes and Measures:

Suicide ideation, lifetime and 12-month stressors, and mental disorders were assessed with questionnaires. Administrative records identified sociodemographic characteristics and suicide attempts.

Results:

A total of 3957 soldiers (3473 [weighted 87.5%] male; 2135 [weighted 52.6%] aged ≤29 years) completed self-administered questionnaires during their deployment in Afghanistan. Lifetime, past-year, and 30-day SI prevalence estimates were 11.7%, 3.0%, and 1.9%, respectively. Among soldiers with SI, 44.2% had major depressive disorder (MDD) and 19.3% had posttraumatic stress disorder in the past 30-day period. A series of analyses of the 23 grouped variables potentially associated with SI resulted in a final model of sex; race/ethnicity; lifetime noncombat trauma; past 12-month relationship problems, legal problems, and death or illness of a friend or family member; and MDD. In this final multivariable model, white race/ethnicity (odds ratio [OR], 3.1 [95% CI, 1.8-5.1]), lifetime noncombat trauma (OR, 2.1 [95% CI, 1.1-4.0]), and MDD (past 30 days: OR, 31.8 [95% CI, 15.0-67.7]; before past 30 days: OR, 4.9 [95% CI, 2.5-9.6]) were associated with SI. Among the 85 soldiers with past 30-day SI, from survey administration through 12 months after returning from deployment, 6% (5 participants) had a documented suicide attempt vs 0.14% (6 participants) of the 3872 soldiers without SI.

Conclusions and Relevance:

This study suggests that major depressive disorder and noncombat trauma are important factors in identifying SI risk during combat deployment.

[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Silverchair Information Systems Icon for PubMed Central
Loading ...
Support Center