Abstract
Posttraumatic stress disorder (PTSD) is one of the most commonly diagnosed psychiatric disorders in the United States and has been linked to suicidal thoughts and behaviors, yet the role of a PTSD diagnosis on functional impairment among suicidal individuals remains unknown. This study examined the association between PTSD status and functional impairment among military psychiatric inpatients admitted for acute suicide risk (N = 166) with a lifetime history of at least one suicide attempt. Measures of functionality included: (1) alcohol use; (2) sleep quality; (3) social problem-solving; and (4) work and social adjustment. Thirty-eight percent of the sample met criteria for PTSD. Women were more likely than men to meet criteria for PTSD (p = 0.007), and participants who met PTSD criteria had significantly more psychiatric diagnoses (p < 0.001). Service members who met PTSD criteria reported more disturbed sleep (p = 0.003) and greater difficulties with work and social adjustment (p = 0.004) than those who did not meet PTSD criteria. However, functionality measures were not significantly associated with PTSD status after controlling for gender and psychiatric comorbidity. Gender and number of psychiatric comorbidities other than PTSD were significant predictors of PTSD in logistic regression models across four functionality measures. Future studies should assess the additive or mediating effect of psychiatric comorbidities in the association between impaired functioning and PTSD. Clinicians are encouraged to assess and address functionality during treatment with suicidal individuals, paying particular attention to individuals with multiple psychiatric diagnoses.
Highlights
Posttraumatic stress disorder (PTSD) and suicide are serious health concerns among U.S military service members and veterans
The current study examined the extent to which functionality was associated with meeting diagnostic criteria for PTSD in a sample of psychiatric inpatients with an acute suicide crisis and at least one lifetime attempted suicide
While it is estimated that between 14% and 16% percent of deployed veterans and military personnel have been diagnosed with PTSD [47], little is known about the prevalence of PTSD
Summary
Posttraumatic stress disorder (PTSD) and suicide are serious health concerns among U.S military service members and veterans. Among over 100,000 returning Iraq and Afghanistan veterans, 25% received at least one mental health diagnosis, and more than half of those were diagnosed with PTSD (52%) [2]. According to the most recent Department of Defense Suicide Event Report (DoDSER) [9], PTSD was among the most common psychiatric diagnoses for individuals with a history of suicide attempt; two-thirds of active duty personnel with a documented suicide attempt received at least one mental health diagnosis, 20% of whom received a PTSD diagnosis. One potential mechanism by which PTSD and suicide may be linked is through impaired functioning. The diathesis-stress model has been applied to several psychiatric diagnoses when describing how biological, historical, and environmental factors impact functionality before and after adverse events. Among individuals who had planned or attempted suicide, 82% reported severe or extreme life impairment, compared to 70% among individuals who had suicide ideation, and 37% among individuals with no suicide ideation [14]
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