The rate of suicidal ideation, suicide plans, suicide attempts and completed suicide among soldiers grown to an increasing number in the past few years. The objective of a recent study1 of military suicide among soliders was to be able to estimate any psychiatric predictors and lifetime prevalence of any suicidal behaviors that were among soldiers in the US Army who were not deployed. A survey that was cross-sectional of 5,428 of non-deployed soldiers participated in this particular study. The results showed the lifetime incidence of suicide plans, suicide attempts and suicidal ideation.
Lifetime prevalence has estimated suicide attempts at 2.4%, suicidal ideation at 13.9% and suicide plans at 5.3%. Many reported cases have stated that 47% to 58.2% had a pre-enlistment onset of behaviors related to suicide among soldiers. Those who were active duty soldiers who met the standard criteria for more than one psychiatric condition, ¾ of them reported an onset of that condition before they enlisted. The pre-enlistment onset rate was lower than that found in civilian surveys in the same age group. Most active duty military with a psychiatric disorder had that disorder prior to enlistment. Those with post-enlistment onsets of suicide plans and suicidal ideation were in fact higher compared to civilians, and those who had post-enlistment onsets first suicide attempts were equal to the civilian rates. The rate of those enlisted in the military who reported suicidal ideation and suicide plans was higher than the rate is civilians, but those who actually made attempted suicide among soldiers was similar to the civilian rate of suicide attempts. Of those who reported suicide plans and suicide attempts, 58.3% and 63.3% were within the first year of the onset of suicidal ideation. That is, the majority of those who actually make suicide attempts among soldiers have been experiencing suicidal ideation for some time.
The post-enlistment suicide attempts were noticed as being related to having a lower rank, previous deployment, and being a woman. Deployed female soldiers had a significant increase in suicide rates during the study. The other factors that have been linked with having a high risk for suicide among soldiers included lack of high school or equivalent education and recent demotions. The factors that were largely linked with the first suicide attempts had occurred during their army service were often led by post-enlistment development of major depression, as well as pre-enlistment that was linked with intermittent explosive disorder or episodic rages. Obsessive-compulsive disorder at pre-enlistment also showed a strong trend when predicting suicide attempts after their enlistments. The factors such as being assigned to Special Operations Command and being unmarried were negatively related to the onset of suicide attempts.
There were five mental disorders that were found to predict post-enlistment first time attempts of suicide among soldiers: pre-enlistment post traumatic stress disorder (PTSD), pre-enlistment panic disorder, pre-enlistment as well as post-enlistment episodic rage or intermittent explosive disorder, and post-enlistment depression. Four out of five, the exception being post traumatic stress disorder, were able to predict suicidal ideation, where post-enlistment episodic rage or intermittent explosive disorder was able to predict suicide attempts among those who had suicidal ideation.
The proportions of any lifetime mental disorders that predict post-enlistment attempted suicide among soldiers are caused by pre-enlistment onset disorders at 31%, the post-enlistment onset disorders at 41%, and for all other mental disorders being at 60%. Cleary suicidal ideation, suicide plans and suicide attempts are related to mental disorders. Additionally, about 1/3 of suicide attempts by enlisted personnel were post-enlistment but tended to be associated with having a pre-enlistment mental disorder.
Fallen heroes who completed suicide towards the end of a 6 year study period had exceeded the general civilian rate of 18 people per every 100,000 people reaching more than 30 individuals per every 100,000 individuals among soldiers who had returned from active deployment to Afghanistan or Iraq in 2009.
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1.Prevalence and Correlates of Suicidal Behavior Among Soldiers: Results From the Army Study to Assess Risk and Resilience in Service members (Army STARRS). Matthew K. Nock, PhD; Murray B. Stein, MD, MPH; Steven G. Heeringa, PhD; Robert J. Ursano, MD; Lisa J. Colpe, PhD, MPH; Carol S. Fullerton, PhD; Irving Hwang, MA; James A. Naifeh, PhD; Nancy A. Sampson, BA; Michael Schoenbaum, PhD; Alan M. Zaslavsky, PhD; Ronald C. Kessler, PhD; JAMA Psychiatry, March, 2014.