Mental health risk factors for suicides in the US Army, 2007-8
Mental health risk factors for suicides in the US Army, 2007-8
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DOI：
10.1136/injuryprev-2011-040112
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发表时间：
2012-12-01
影响因子：
3.7
通讯作者：
Jones, Bruce H.
中科院分区：
文献类型：
--
作者：
Bachynski, Kathleen E.;Canham-Chervak, Michelle;Jones, Bruce H.
自2004年以来，现役美国陆军人员的自杀率一直在上升，2008年超过了可比的平民自杀率。这项分析使用美国军方的数据来评估2007-2008年两年期间的自杀率，并检验与精神健康障碍相关的自杀相对风险(RR)。方法使用陆军G-1(人员)1977-2008年的数据来评估美国陆军自杀的历史趋势。利用国防伤亡信息处理系统和国防医学监测系统的数据计算自杀发生率、RR和2000-2008年精神卫生障碍的趋势。结果2007-2008年共有255名士兵自杀，2008年的自杀率为20.2/10万。自杀风险较高的相关因素包括男性、入伍级别较低和门诊治疗的精神健康障碍(RR 3.9)，以及一些精神健康障碍(情绪障碍、焦虑障碍、创伤后应激障碍、个性/精神障碍、与物质相关的障碍和适应障碍；RR范围为4.7-24.5)。对历史趋势的分析表明，2008年发生的自杀事件中有25%-50%可能与部队从2003年开始投入战斗的重大承诺有关。结论近年来自杀人数的增加与全军精神障碍患病率的上升是同步的。这一发现表明，接受临床治疗的精神病理学的比率增加与自杀率的增加有关；这些比率可能是该人群中自杀风险的哨兵。寻求治疗精神障碍和药物滥用的士兵应该成为预防自杀的重点。
Objective Suicides among active duty US Army personnel have been increasing since 2004, surpassing comparable civilian rates in 2008. This analysis uses US military data to assess suicide rates for the 2-year period 2007-8, and examines relative risks (RR) of suicide associated with mental health disorders.Methods Historical trends of US Army suicides were assessed using 1977-2008 data from Army G-1 (Personnel). Suicide rates, RR and the 2000-8 trends of mental health disorders were calculated using data from the Defense Casualty Information Processing System and Defense Medical Surveillance System.Results A total of 255 soldiers committed suicide in 2007-8 (2008 rate 20.2 per 100 000). Factors associated with higher suicide risk included male gender, lower enlisted rank and mental health disorders treated on an outpatient basis (RR 3.9), as well as a number of mental health disorders (mood disorders, anxiety disorders, post-traumatic stress disorder, personality/psychotic disorders, substance-related disorders and adjustment disorder; RR range 4.7-24.5). Analysis of historical trends suggested that 25-50% of the suicides that occurred in 2008 might have been related to the major commitment of troops to combat beginning in 2003.Conclusions The recent increase in suicides parallels an increase in the prevalence of mental disorders across the army. This finding suggests that increasing rates of clinically treated psychopathology are associated with increasing rates of suicides; these rates probably serve as sentinels for suicide risk in this population. Soldiers seeking treatment for mental disorders and substance abuse should be a focus for suicide prevention.