Psychological autopsy study comparing suicide decedents, suicide ideators, and propensity score matched controls: results from the study to assess risk and resilience in service members (Army STARRS).
Psychological autopsy study comparing suicide decedents, suicide ideators, and propensity score matched controls: results from the study to assess risk and resilience in service members (Army STARRS).
复制标题
DOI：
10.1017/s0033291717001179
复制
发表时间：
2017-11
影响因子：
6.9
通讯作者：
Benedek D
中科院分区：
文献类型：
--
作者：
Nock MK;Dempsey CL;Aliaga PA;Brent DA;Heeringa SG;Kessler RC;Stein MB;Ursano RJ;Benedek D
在过去的十年里，美国陆军士兵的自杀率大幅上升。在这里，我们报告的第一个结果，从一个大型的心理尸检研究，使用两个对照组，旨在揭示自杀死亡的危险因素，士兵超出已知的社会人口因素和自杀意念的存在。告密者是近亲和陆军监督员：135例自杀病例，137名对照士兵在已知的自杀和陆军历史变量的社会人口学风险因素上的倾向得分匹配，118名对照士兵在过去一年中报告自杀意念。结果显示，自杀死亡的军人中，大部分（79.3%）有精神障碍病史，其中自杀死亡前30天内的精神障碍是自杀死亡的主要危险因素。大约一半的自杀者告诉别人他们正在考虑自杀。在这项研究中发现的几乎所有危险因素在自杀病例和倾向评分匹配的对照组之间都有差异，但在自杀病例和自杀意念者之间没有显著差异。自杀者和构想者之间最显著的区别是前者存在内化障碍（特别是抑郁症）和多种疾病（即，3+疾病）在过去30天内。大多数死于自杀的士兵在死前不久都有可识别的精神障碍，并告诉其他人他们的自杀想法，这表明有预防和干预的机会。然而，很少有危险因素区分自杀意念者和死者，指出了未来研究的一个重要方向。
The suicide rate has increased significantly among US Army soldiers over the past decade. Here we report the first results from a large psychological autopsy study using two control groups designed to reveal risk factors for suicide death among soldiers beyond known sociodemographic factors and the presence of suicide ideation. Informants were next-of-kin and Army supervisors for: 135 suicide cases, 137 control soldiers propensity-score-matched on known sociodemographic risk factors for suicide and Army history variables, and 118 control soldiers who reported suicide ideation in the past year. Results revealed that most (79.3%) soldiers who died by suicide have a prior mental disorder; mental disorders in the prior 30-days were especially strong risk factors for suicide death. Approximately half of suicide decedents tell someone that they are considering suicide. Virtually all of the risk factors identified in this study differed between suicide cases and propensity-score-matched controls, but did not significantly differ between suicide cases and suicide ideators. The most striking difference between suicides and ideators was the presence in the former of an internalizing disorder (especially depression) and multi-morbidity (i.e., 3+ disorders) in the past 30 days. Most soldiers who die by suicide have identifiable mental disorders shortly before their death and tell others about their suicidal thinking, suggesting that there are opportunities for prevention and intervention. However, few risk factors distinguish between suicide ideators and decedents, pointing to an important direction for future research.