Gender Differences in Lifetime Prevalence and Onset Timing of Suicidal Ideation and Suicide Attempt Among Post-9/11 Veterans and Nonveterans
Gender Differences in Lifetime Prevalence and Onset Timing of Suicidal Ideation and Suicide Attempt Among Post-9/11 Veterans and Nonveterans
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DOI：
10.1097/mlr.0000000000001431
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发表时间：
2021-02-01
期刊：
影响因子：
3
通讯作者：
Schneiderman, Aaron I.
中科院分区：
文献类型：
--
作者：
Hoffmire, Claire A.;Monteith, Lindsey L.;Schneiderman, Aaron I.
背景：美国自杀率的上升在退伍军人中尤其明显，尤其是女性。目前尚不清楚这些差异是否延伸到自杀意念（SI）和自杀企图（SA），这是自杀的主要预测因素。比较退伍军人和非退伍军人之间SI和SA患病率和发病时间的文献有限。目的：本研究的目的是估计和比较退伍军人和非退伍军人之间的SI和SA患病率和发病时间相对于年龄和兵役，按性别。研究设计：对来自比较健康评估访谈研究的横截面数据进行性别分层分析。广义估计方程logistic回归用于比较不同时间段和各组之间SI和SA的患病率和发病率，控制每个时间段的风险年数。受试者：15，082名9/11后退伍军人（36.7%女性）和4638名非退伍军人（30.5%女性）的国家样本。措施：哥伦比亚自杀严重程度评定量表适用于评估SI和SA相对于年龄（小于18岁，18岁及以上）和兵役（前，期间和后军事）。结果如下：与非退伍军人男性相比，退伍军人男性经历了显著更高的终身SI的几率（比值比=1.13），而与非退伍军人女性相比，退伍军人女性经历了显著更高的终身SA的几率（比值比=1.35）。SI和SA发病差异很大，退伍军人和nonveterans和退伍军人群体内的性别。结论：退伍军人和非退伍军人似乎在SI和SA的风险期不同。此外，退伍军人SI和SA发病的性别差异突出了需要性别知情的退伍军人自杀预防策略，目标是最高风险的时期。
Background: Rising US suicide rates are particularly notable among military veterans, especially women. It is unknown whether these differences extend to suicidal ideation (SI) and suicide attempts (SA), which are major predictors of suicide. Literature comparing SI and SA prevalence and timing of onset between veterans and nonveterans is limited. Objective: The objective of this study was to estimate and compare SI and SA prevalence and onset timing relative to age and military service between veterans and nonveterans, by gender. Research Design: Gender-stratified analysis of cross-sectional data from the Comparative Health Assessment Interview Study. Generalized estimating equations logistic regression was used to compare prevalence and onset of SI and SA between time periods and across groups, controlling for years at risk in each time period. Subjects: National sample of 15,082 post-9/11 veterans (36.7% women) and 4638 nonveterans (30.5% women). Measures: Columbia-Suicide Severity Rating Scale adapted to assess SI and SA relative to age (less than 18 y, 18 y and above) and military service (pre-, during, and post-military). Results: Veteran men experienced significantly higher odds of lifetime SI compared with nonveteran men (odds ratio=1.13), whereas veteran women experienced significantly higher odds of lifetime SA compared with nonveteran women (odds ratio=1.35). SI and SA onset varied considerably for veterans and nonveterans and by gender within veteran groups. Conclusions: Veterans and nonveterans appear to differ in periods of risk for SI and SA. Furthermore, gender differences in SI and SA onset for veterans highlight the need for gender-informed veteran suicide prevention strategies that target periods of highest risk.