Abstract
Psychiatric hospitalization for a suicide attempt (SA), rather than suicide ideation (SI) alone, is a stronger risk indicator for eventual suicide death. Yet, little is known about demographic and clinical characteristics differentiating those admitted for SA versus SI. Understanding these differences has implications for assessment and treatment. A retrospective review of electronic medical records (EMRs) was performed on service members (n = 955) admitted for SA or SI at the Walter Reed Army Medical Center between 2001–2006. Service members hospitalized for SA were younger compared to those hospitalized for SI. The proportion of women admitted for SA was significantly higher than those admitted for SI whereas their male counterparts showed the opposite pattern. Patients admitted for SA, versus SI, had significantly higher prevalence of adjustment disorder with mixed disturbance of emotion and conduct (MDEC), personality disorder not otherwise specified (PDNOS), and borderline personality disorder (BPD). Patients admitted for SI had significantly higher prevalence of adjustment disorder with depressed mood and deferred Axis II diagnosis, compared to those admitted for SA. There were no significant between-group differences in the average or median number of documented prior suicide attempts. Findings highlight the need for more standardized assessment, diagnostic decision-making, and documentation practices for all patients.
Highlights
Suicide is a major public health concern
This study examined the demographic and clinical characteristics of U.S active duty service members admitted for psychiatric inpatient care for a suicide attempt versus suicide ideation severe enough to warrant hospitalization
Findings based on a retrospective chart review indicate that those in the suicide attempt (SA) group were notably younger compared with those in the suicide ideation (SI) group; this finding is supported by published civilian epidemiological data [9]
Summary
Suicide is a major public health concern. According to the World Health Organization (WHO), global deaths by suicide total nearly 793,000 individuals annually [1]. In the United States (U.S.), approximately 47,173 individuals died by suicide in 2017 [2]. Suicide is the tenth leading cause of death in the U.S [3] and currently the leading cause of death among U.S military personnel [4]. In. 2016, 21 suicide deaths occurred per 100,000 active duty service members, and this suicide mortality rate has remained steady since 2011 [5]. While the Department of Defense (DoD) historically reported lower suicide rates among military service members compared to civilians [6], age- and sex-adjusted suicide rates across military and civilian populations have become comparable since 2009 [7]
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