A Retrospective Chart Review Examination of Demographic, Military, and Psychiatric Differences among Psychiatric Inpatients Admitted for Suicide-Ideation versus Suicide Attempt with an Emphasis on Gender

Abstract

Abstract : Background: Psychiatric hospitalizations, due to suicide ideation (SI) or suicide attempt (SA), are a risk factor for fatal and non-fatal suicidal self-directed violence. Mental health related inpatient stays are now the leading cause of hospitalizations within the Armed Forces, yet little is known about suicidal military psychiatric inpatients. Purpose: (1) To describe the demographic, military service, psychiatric, and hospitalization-related characteristics of a sample of service members psychiatrically hospitalized for suicide-related events; (2) To examine differences between patients admitted for SI versus SA across a number of available data categories; and (3) To determine if the observed significant differences among these two groups are maintained when adjusting for gender. Method: A retrospective, cross-sectional, review of Electronic Medical Records (EMR) of 955 active-duty military, Reserve, and National Guard members psychiatrically hospitalized for SI (n = 534) versus SA (n = 421) at the Walter Reed Army Medical Center (between 2001 and 2006) was performed. Results: The sample was primarily men (69%), from the Army, with an average age of 26. Men were overrepresented in the SI group whereas women were overrepresented inthe SA group. Individuals in the SI group were significantly more likely to demonstrate documented Adjustment Disorder with Depressed Mood, deferred Axis II diagnosis, unidentified lifetime trauma, and psychosocial stressors associated with adjustment to military life. In comparison, individuals in the SA group were significantly more likely to demonstrate Adjustment Disorder with Mixed Disturbance of Emotion and Conduct, Borderline Personality Disorder, Personality Disorder Not Otherwise Specified, childhood sexual abuse and adulthood domestic violence trauma histories, and psychosocial stressors associated with end of military service.