Suicide Ideation, Plans, and Attempts Among Military Veterans vs Nonveterans With Disability.
Suicide Ideation, Plans, and Attempts Among Military Veterans vs Nonveterans With Disability.
复制标题
DOI：
10.1001/jamanetworkopen.2023.37679
复制
发表时间：
2023-10-02
影响因子：
13.8
通讯作者：
Marlow, Nicole M.
中科院分区：
文献类型：
--
作者：
Blais, Rebecca K.;Xie, Zhigang;Kirby, Anne V.;Marlow, Nicole M.
在美国军队服役与残疾人的自杀风险有关吗？在这项调查研究中，来自231099名美国成年人的自我报告横截面数据，代表超过2.36亿人，在军队服役与无残疾者的自杀风险较高相关。然而，在残疾人中，与残疾的非退伍军人相比，服兵役与较低的自杀风险相关。这些发现表明，在美国成年人的一个亚群中，服兵役可能是防止自杀的一个保护因素。这项调查研究评估了退伍军人身份是否与残疾人自杀风险更高有关。残疾人自杀意念、计划和企图的风险更高，随着残疾限制数量的增加，风险也在增加。退伍军人的自杀死亡率和残疾率高于非退伍军人。评估退伍军人身份是否与残疾人自杀风险增加相关。这项调查研究使用了参加2015 - 2020年全国药物使用和健康调查的美国成年人的横断面自我报告数据。数据经过加权以代表总体。数据分析于二零二二年七月至八月进行。自杀意念、计划和企图是主要结局。残疾状态（存在或不存在）和残疾限制数量（1、2或≥ 3）作为因素。退伍军人身份是根据自我报告（退伍军人或非退伍军人）确定的。多变量logistic回归分析了自杀意念、计划和企图作为退伍军人状态和残疾变量的函数。参与者包括231099名美国退伍军人和非退伍军人，代表236551727名美国成年人，其中20.03%（加权n = 47 397 876）报告了残疾限制，8.92%为退伍军人（加权n = 21 111 727; 16.0%年龄35 - 49岁; 91.0%男性; 6.7%西班牙裔; 10.9%非西班牙裔黑人; 78.4%非西班牙裔白色）和91.08%非退伍军人（加权n = 215 440 000; 25.4%年龄为35 - 49岁; 44.0%男性; 16.5%西班牙裔; 11.7%非西班牙裔黑人; 63.3%非西班牙裔白色）。总体而言，4.39%的人报告了自杀意念、计划或企图（加权n = 10 401 065）。在那些没有残疾的人中，退伍军人身份与自杀计划的风险较高相关（调整后的比值比[AOR]，1.71; 95%CI，1.17 - 2.49）。在那些有1或2个残疾限制的人中，退伍军人与自杀计划（AOR，0.57; 95%CI，0.34 - 0.95）和企图史（AOR，0.46; 95%CI，0.24 - 0.88）的风险较低相关。在这项研究中，自杀风险如何作为残疾和退伍军人身份的函数而不同，残疾退伍军人自杀死亡的风险相对于残疾非退伍军人较低。退伍军人身份可能会降低自杀的风险，因为通过退伍军人事务部获得更多与残疾有关的护理。进一步的研究将通过审查残疾的原因和类型以及对自我价值的残疾的看法来扩展这一调查路线。战争造成的身体创伤可能具有保护性，因为为国家服务的意义和价值。
Is service in the US military associated with suicide risk among those with disability? In this survey study with self-reported cross-sectional data from 231 099 US adults, representing more than 236 million individuals, service in the military was associated with higher suicide risk among those without disability. However, among those with disability, military service was associated with lower suicide risk compared with nonveterans with disability. These findings suggest that military service could be a protective factor against suicide among a subpopulation of US adults. This survey study evaluates whether veteran status is associated with greater risk for suicide among those with disability. People with disability are at heightened risk for suicide ideation, planning, and attempt, with risk growing as the number of disabling limitations increases. Military veterans have higher rates of suicide deaths and disability relative to nonveterans. To evaluate whether veteran status is associated with greater risk for suicide in those with disability. This survey study used cross-sectional self-reported data from US adults who participated in the 2015-2020 National Survey on Drug Use and Health. Data were weighted to represent the population. Data analysis was conducted from July to August 2022. Suicide ideation, planning, and attempt served as primary outcomes. Disability status (present or absent) and number of disabling limitations (1, 2, or ≥3) served as factors. Veteran status was determined based on self-report (veteran or nonveteran). Multivariable logistic regression examined suicide ideation, planning, and attempt as a function of veteran status and disability variables. Participants included 231 099 US veterans and nonveterans, representing 236 551 727 US adults, of whom 20.03% (weighted n = 47 397 876) reported a disabling limitation, 8.92% were veterans (weighted n = 21 111 727; 16.0% aged 35-49 years; 91.0% men; 6.7% Hispanic; 10.9% non-Hispanic Black; and 78.4% non-Hispanic White) and 91.08% were nonveterans (weighted n = 215 440 000; 25.4% aged 35-49 years; 44.0% male; 16.5% Hispanic; 11.7% non-Hispanic Black; and 63.3% non-Hispanic White). Overall, 4.39% reported suicide ideation, planning, or attempt (weighted n = 10 401 065). Among those with no disability, veteran status was associated with higher risk of suicide planning (adjusted odds ratio [AOR], 1.71; 95% CI, 1.17-2.49). Among those with 1 or 2 disabling limitations, being a veteran was associated with a lower risk of suicide planning (AOR, 0.57; 95% CI, 0.34-0.95) and history of attempt (AOR, 0.46; 95% CI, 0.24-0.88). In this study of how suicide risk differs as a function of disability and veteran status, risk for death by suicide was lower among veterans with disability relative to nonveterans with disability. Veteran status may mitigate risk for suicide given increased receipt of more disability-related care through the Department of Veterans Affairs. Further research would extend this line of inquiry by examining the cause and type of disability as well as perceptions of disability on self-worth. It is possible that physical wounds of war are protective because of the meaning and value of service to one’s country.
登录
查看更多内容
影响因子：
3.7
作者：
通讯作者：
--
影响因子：
6.9
作者：
Herzog, Sarah;Tsai, Jack;Pietrzak, Robert H.
通讯作者：
Pietrzak, Robert H.
影响因子：
3.3
作者：
Keller, Amber V.;Clark, Jillian M. R.;Twamley, Elizabeth W.
通讯作者：
Twamley, Elizabeth W.
影响因子：
3.8
作者：
Keegan RJ;Flood A;Niyonsenga T;Welvaert M;Rattray B;Sarkar M;Melberzs L;Crone D
通讯作者：
Crone D
影响因子：
2.7
作者：
Cameron, Rebecca P.;Mona, Linda R.;Lemos, Larry
通讯作者：
Lemos, Larry