Suicide Attempts in the US Army During the Wars in Afghanistan and Iraq, 2004 to 2009.
Suicide Attempts in the US Army During the Wars in Afghanistan and Iraq, 2004 to 2009.
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DOI：
10.1001/jamapsychiatry.2015.0987
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发表时间：
2015-09
期刊：
影响因子：
25.8
通讯作者：
Army Study to Assess Risk and Resilience in Servicemembers Collaborators
中科院分区：
文献类型：
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作者：
Ursano RJ;Kessler RC;Stein MB;Naifeh JA;Aliaga PA;Fullerton CS;Sampson NA;Kao TC;Colpe LJ;Schoenbaum M;Cox KL;Heeringa SG;Army Study to Assess Risk and Resilience in Servicemembers Collaborators
在阿富汗和伊拉克战争期间，美军自杀未遂率急剧上升。由于军队管理数据系统之间缺乏整合，对这一重要健康成果的全面研究一直受到阻碍。使用陆军研究数据确定2004-2009年间陆军自杀未遂的风险因素，以评估军人的风险和复原力(陆军STARR)。在研究期间，正规陆军士兵中有9,791起有医学记录的自杀未遂。分析了来自陆军和国防部行政数据系统的个人级别的人月记录，以从183,826人月的等概率对照样本中识别社会人口统计、服务相关和心理健康风险因素，以区分自杀未遂病例。自杀企图通过国防部自杀事件报告记录和ICD-9 E95x诊断代码进行识别。预测变量是从军队人员和医疗记录中构建的。应征入伍士兵占所有自杀未遂的98.6%，总体自杀率为377/10万人年，而军官为27.9/10万人年。入伍士兵中显著的多变量预测因素包括社会人口学特征(女性、入伍时年龄较大、当前年龄较小、受教育程度较低、非西班牙裔白人)、服役时间短、从未或以前服役，以及精神健康诊断的存在和最近。在军官中，只有社会人口特征(女性、入伍时年龄较大、当前年龄较小、教育程度较低)以及精神健康诊断的存在和近期情况具有重要意义。结果代表了迄今为止对美国军队自杀企图的最全面的统计，并揭示了应征士兵和军官的独特风险概况，并突显了将研究和预防努力集中在应征士兵第一次服役的重要性。
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. 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). 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. 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. 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. 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.