Potential Risk Factors For Suicide Research Articles

Risk Factors for Suicide Among Professional Athletes.

Suicide is a major public health concern that affects all demographics. Risk factors for suicide in professional athletes are poorly understood compared with the general population. The goal of this study was (1) to explore the current literature on risk factors for suicide in the population of professional athletes and (2) to formulate a proposed suicide risk identification tool as the first step in the production of a validated screening method specific to this population. A comprehensive literature search for relevant publications was carried out through 7 databases. There is some evidence to suggest that retirement, anabolic androgenic steroid use, sexual abuse victimization, health problems, financial issues, relationship issues, having immigrant parents, having a financially disadvantaged childhood, using self-blame or behavioral disengagement as a coping strategy, changes in appetite or weight, sleep problems, reduced competitiveness, and thinking about a career after retirement are potential risk factors for suicide in this population. There is limited evidence to suggest that having a career in elite or professional sports, participation in contact sports, and participating in specific sports that are not associated with a higher suspected prevalence of performance-enhancing drug use are potential risk factors. This study identified potential risk factors for suicide among elite and professional athletes. These findings were used to help formulate a proposed suicide risk identification tool. Future research is recommended to explore and clarify specific risk factors for suicide in this population and to test the validity of the proposed tool.

Body Weight Variability and Risk of Suicide Mortality: A Nationwide Population-Based Study

Background. Suicide is a pressing global health concern, and identifying its risk factors is crucial for prevention. Body weight variability (BWV) has been increasingly recognized as a potential factor impacting physical and mental health outcomes. We aimed to explore the relationship between BWV and the risk of suicide mortality using a nationally representative database. Methods. This population-based cohort study used data from the Korean National Health Insurance Database and included a total of 1,983,701 subjects. BWV was assessed using at least three health examination datasets and validated variability indices (variability independent of the mean (VIM), average successive variability, and coefficient of variation), and patients were divided into BWV quartiles (Q1–Q4). The primary endpoint was suicide-related death. Results. During a median of 11.3 years of follow-up, 5,883 suicide deaths occurred. A higher baseline body weight was associated with a lower risk of suicide. However, greater BWV (VIM) was associated with a significantly greater risk of suicide (adjusted hazard ratio [95% confidence interval], 1.35 [1.26–1.45] in the Q4 group), even after adjusting for baseline body mass index (BMI). Similar results were observed regardless of obesity or BMI category. Consistent findings were observed when using different variability indices. Subgroup analyses according to sex, age, diabetes, and depression also supported these findings. Conclusion. Our study highlights the importance of considering BWV as a potential risk factor for suicide.

Distinct correlation network of clinical characteristics in suicide attempters having adolescent major depressive disorder with non-suicidal self-injury

Suicidal behavior and non-suicidal self-injury (NSSI) are common in adolescent patients with major depressive disorder (MDD). Thus, delineating the unique characteristics of suicide attempters having adolescent MDD with NSSI is important for suicide prediction in the clinical setting. Here, we performed psychological and biochemical assessments of 130 youths having MDD with NSSI. Participants were divided into two groups according to the presence/absence of suicide attempts (SAs). Our results demonstrated that the age of suicide attempters is lower than that of non-attempters in participants having adolescent MDD with NSSI; suicide attempters had higher Barratt Impulsiveness Scale (BIS-11) impulsivity scores and lower serum CRP and cortisol levels than those having MDD with NSSI alone, suggesting levels of cortisol and CRP were inversely correlated with SAs in patients with adolescent MDD with NSSI. Furthermore, multivariate regression analysis revealed that NSSI frequency in the last month and CRP levels were suicidal ideation predictors in adolescent MDD with NSSI, which may indicate that the increased frequency of NSSI behavior is a potential risk factor for suicide. Additionally, we explored the correlation between psychological and blood biochemical indicators to distinguish suicide attempters among participants having adolescent MDD with NSSI and identified a unique correlation network that could serve as a marker for suicide attempters. Our research data further suggested a complex correlation between the psychological and behavioral indicators of impulsivity and anger. Therefore, our study findings may provide clues to identify good clinical warning signs for SA in patients with adolescent MDD with NSSI.

Upstream suicide prevention in the U.S. Army: Noncommissioned officers' perspectives.

The goal of this study was to examine the factors associated with Army noncommissioned officer (NCO) experiences, attitudes, and behaviors in their role of identifying potential suicide risk factors in their fellow soldiers. To better understand the perspectives of NCOs, an anonymous survey was administered to 2,468 Army NCOs. Descriptive statistics and linear regressions were conducted to compare subgroups of NCOs. Most (71%) Army NCOs have received many (11 or more) hours of suicide prevention training, but training in soft skills that may be important for the gatekeeper role was less consistently reported. Active Component soldiers reported greater confidence in their intervention skills (Cohen's d = 0.25) and fewer logistical barriers (e.g., time and space to talk) to intervening with at-risk soldiers (Cohen's d = 0.80) compared to Reserve and National Guard soldiers. Formal coursework in mental health areas like psychology or chaplaincy was associated with a greater level of confidence in intervention skills (Cohen's d = 0.23) and in more frequent intervention behavior (Cohen's d = 0.13). Army NCO trainings should be modified to better equip soldiers with the soft skills (e.g., active listening skills and verbally and nonverbally conveying nonjudgment/acceptance and empathy) needed to have effective conversations with soldiers about suicide risk factors and other sensitive topics. Strategies used within mental health education, which appears to be a strength for NCO gatekeepers, could be used to achieve this goal. Reserve and Guard NCOs may need additional supports and tailored trainings to better fit their operational context. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Living on the edge: a review on potential risk factors for suicide in adult attention-deficit/hyperactivity disorder

IntroductionAttention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by symptoms including inattention, hyperactivity and/or impulsivity that commonly persists into adulthood. Suicide is a major cause of death in adult ADHD (aADHD) patients. Suicidality is higher in these patients, in possible relationship to various clinical and socio-demographic factors.ObjectivesTo review the current literature concerning potential risk factors for suicide in aADHD patients.MethodsA research was made using the Medline database through the Pubmed search engine, with the following keywords: “adhd”, “suicide”, “risk factors”.ResultsComorbid psychiatric disorders (major depressive disorder, sleep disturbances, behavior disorders and addictive disorders) are powerful predictors of suicidal behavior in aADHD. Depression is the most frequent diagnosis among aADHD patients with previous suicide attempts. Subtype (mostly the combined type) and severity of ADHD were also associated with a higher number of prior suicide attempts. Impulsiveness, poor emotional self-regulation, recklessness, persistent hyperactivity, inability to relax, engagement in risk behavior (often found in ADHD), common personality traits in aADHD like low frustration tolerance, maladaptive coping and poor problem-solving, as well as interpersonal relationship problems, were associated with higher suicidality. Financial distress caused by unemployment is associated with higher suicidal behaviors. The suicidality is higher in females, mostly associated to self-concept, whereas in males is typically related to impulsivity.ConclusionsClinicians should be aware of the potential risk factors for suicide in aADHD patients because the early detection of these factors is fundamental to improve the patients’ quality of life and could contribute to the design of more effective treatments.DisclosureNo significant relationships.

Suicidality in individuals with Prader-Willi syndrome: a review of registry survey data

IntroductionPrader–Willi syndrome (PWS) is a rare, genetic, neurodevelopmental syndrome associated with hyperphagia and early onset obesity, growth and sex hormone insufficiencies, mild-to-moderate intellectual disability, and behavioral challenges such as compulsivity, anxiety, skin picking, social skills deficits and temper outbursts. Given high rates of psychiatric comorbidity and potential risk factors for suicide in PWS, this study sought a first estimate of the prevalence of suicidal ideation (SI) and attempts (SA) in the PWS population and any characteristics associated with suicidality in this population.MethodsUsing the Global Prader-Willi Syndrome Registry, we included all participants who had answered a question about SI. We examined the most recent data from the surveys about social, economic, and demographic factors, genetic subtype, and psychiatric symptoms and treatments. A chi-square analysis was used to compare registry participants who reported SI to those without reported SI.ResultsFrom 750 included survey respondents, 94 (12.5%) endorsed some history of SI. Of these, 25 (26.6%) also reported a history of SA, with an average age of 16.25 years at their first attempt. Those with a history of SI were predominantly male and adult age, and had higher rates of aggression and psychiatric comorbidities, therapies, and medications.ConclusionsThis study indicates that the rate of SI and SA in PWS is comparable to the general population, and that suicide attempts in PWS typically begin in middle-teenage years. Despite unique challenges, individuals with PWS and their caregivers should be included in screens and psychoeducation for suicide and mental health concerns.

Sociodemographic Factors, Health Behaviors, and Biological Indicators Associated With Suicide Mortality Among Young Adults in South Korea: A Nationwide Cohort Study Among 15 Million Men and Women.

The role of sociodemographic factors, health behaviors, and biological indicators as potential risk factors for suicide is relatively understudied among young adults. The aim of this study is to explore the association of these variables with the risk of death by suicide among young adults. The study population consisted of 15,534,438 individuals aged 20-39 years from the Korean National Health Insurance Service. Sociodemographic factors associated with death by suicide during 2006-2015 were evaluated. 3,396,353 individuals who underwent health examinations between 2002 and 2005 were separately assessed for health behaviors and biological indicators associated with death by suicide. Cox proportional hazards regression analysis was used to determine the hazard ratios (HRs) and 95% confidence intervals (CIs) for suicide mortality according to sociodemographic factors (age, household income, job status, residence, and Charlson comorbidity index score), health behaviors (physical activity, smoking, and alcohol consumption), and biological indicators (blood pressure, total cholesterol level, body mass index, and fasting serum glucose level). Low household income, self- and non-employment, increased comorbidity, smoking, and normal weight elevated the risk of death by suicide among young adults. While older age was associated with elevated risk for death by suicide among men (adjusted HR [aHR] = 2.11; 95% CI, 2.02-2.20 for men aged 35-39 years), older age reduced the risk for death by suicide among women (aHR = 0.72; 95% CI, 0.69-0.75 for women aged 35-39 years). Elevated blood pressure and fasting serum glucose level were associated with increased risk for death by suicide among men (aHR = 1.16; 95% CI, 1.05-1.28 and aHR = 1.48; 95% CI, 1.26-1.75, respectively). Finally, high total cholesterol levels were associated with increased risk for death by suicide among women (aHR = 1.59; 95% CI, 1.19-2.13). Sociodemographic factors, health behaviors, and biological indicators were associated with suicide mortality among young adults.

Association of ACE Gene Insertion/Deletion Polymorphism with Suicidal Attempt in an Iranian Population.

Deregulation of the renin-angiotensin system (RAS) plays an important role in suicide. Angiotensin converting enzyme (ACE) gene is a key component in this system. The relationship between insertion/deletion (I/D) polymorphism of ACE gene with suicide attempt (SA) is controversial. According to previous studies, allele D in this polymorphism has been considered as a potential risk factor for suicide. However, no study has been conducted in Iran to investigate this matter. This case-control study has focused on investigating the association of ACE I/D polymorphism (rs1799752) with SA in an Iranian population. The frequency of genotypes was 14% for II, 55% for ID, and 31% for DD in the case group (100 persons), and 18% for II, 74% for ID, and 8% for DD in control group (100 persons). Results show there was a significant difference in the distribution of ACE I/D polymorphism genotypes in men with SA compared to controls, as well as in women with SA compared to controls. Also, there was a significant association between DD genotype and the risk of SA compared to II genotype as reference. The severity of depression was significantly different between DD and II genotypes in SA group. According to the results, we suggest that the presence of DD genotype is possibly associated with an increased risk of SA. Maybe part of that is related to severity of depression in DD genotypes carriers of ACE I/D polymorphism.

Association of T. gondii infection with suicide: a systematic review and meta-analysis

BackgroundFindings on the association between Toxoplasma gondii (T. gondii) infection and suicide are contradictory. This paper aimed to resolve this uncertainty by conducting a meta-analysis.MethodsWe found the relevant studies using keywords include “Toxoplasmosis” and “Suicide” and the related synonyms in international databases such as ISI, Medline, and Scopus. The eligible studies were included in the meta-analysis phase. The random effect approach was applied to combine the results.ResultsOut Of 150 initial studies, 15 were included in the meta-analysis. Odds of suicide in people with T. gondii infection was 43% (OR: 1.43, 95%CI; 1.15 to 1.78) higher than those without this infection. The test for publication bias was not statistically significant, which indicates the absence of likely publication bias.ConclusionThis study confirms that T. gondii infection is a potential risk factor for suicide. To reduce cases of suicide attributable to T. gondii infection, it is recommended to implement some measures to prevent and control the transmission of the disease.

Combined effects of depression and anxiety on suicide: A case-control psychological autopsy study in rural China

Most of the previous researches indicated depression and anxiety were potential risk factors for suicide, and they were also highly correlated. However, few studies have explored their combined effects on suicide and the dimensions which really work. A total of 392 suicide cases aged 15–34 years and 416 community controls of the same age range were investigated. The results showed that after controlling confounding factors, people with low depression and high anxiety, with high depression and low anxiety, with high depression and high anxiety were at 2.46, 26.32, 54.77 times more risk for suicide (all P < 0.05), compared with subjects with low depression and low anxiety. Only two of seven dimensions of depression (including cognitive disturbance, helplessness, excluding anxiety dimension) and one of two dimensions of STAI anxiety (anxiety dimension, not depression dimension) were risk factors for suicide (all OR > 1). Our main findings was that combined effects of depression and anxiety on suicide were complicated, and the effects of anxiety dimension of depression and depression dimension of anxiety must be cautiously evaluated, avoiding overlapping inclusion.

Anhedonia and suicidal thoughts and behaviors in psychiatric outpatients: The role of acuity.

Anhedonia-impairment related to the experience of pleasure-has been identified as a potential risk factor for suicide, with some mixed findings. The current study sought to clarify the role of acuity of anhedonia in the relationship between anhedonia and suicidal thoughts and behaviors by comparing acutely and chronically anhedonic subjects on severity of suicidal ideation (SI) and suicide attempt (SA) history. Psychiatric outpatients (N=395) were administered the Columbia Suicide Severity Rating Scale, the Beck Scale for Suicidal Ideation and a modified version of the Snaith-Hamilton Pleasure Scale (SHPS); SI measures were readministered at a 1-month follow-up (N=289, 73%). Participants were classified as acutely anhedonic, chronically anhedonic and nonanhedonic based on their responses to the SHPS at initial assessment. Controlling for symptoms of anxiety and depression, acute anhedonia was cross-sectionally and prospectively associated with greater severity of SI compared to the nonanhedonic group; no differences in severity of SI were found between the chronically anhedonic and nonanhedonic group at either time point. Anhedonia grouping was not associated with SA history. Changes in capacity to experience pleasure may be more informative of near-term SI than typically low pleasure levels. Future investigation should focus on the relationship between acute anhedonia and imminent suicidal behavior.

Sociodemographic Factors, Health Behaviors, and Biological Indicators Associated With Suicide Mortality Among Young Adults in South Korea: A Nationwide Cohort Study Among 16 Million Men and Women

Background: The role of sociodemographic factors, health behaviors, and biological indicators as potential risk factors for suicide is relatively understudied among young adults. The aim of this study is to determine the association of sociodemographic factors, health behaviors, and biological indicators on the risk of death from suicide among young adults. Methods and Findings: The study population consisted of 16,277,532 individuals aged 20-39 years from the Korean National Health Insurance Service. Sociodemographic factors, determined at 2005, associated with death from suicide during 2006-2015 were evaluated. Furthermore, 2,055,789 individuals who underwent health examinations between 2002-2005 were separately assessed for health behaviors and biological indicators associated with death from suicide. Cox proportional hazards regression analysis was used to determine the hazard ratios (HRs) and 95% confidence intervals (CIs) for the risk of death from suicide according to sociodemographic factors (age, household income, job status, residence, and Charlson comorbidity index), health behaviors (smoking, physical activity, and alcohol consumption), and biological indicators (body mass index, blood pressure, fasting serum glucose, and total cholesterol). Low household income, non-employment, increased comorbidity, smoking, and normal weight elevated the risk of death from suicide among young adults. While older age was associated with elevated risk for death from suicide among men, older age reduced the risk for death from suicide among women. Elevated blood pressure and fasting serum glucose were associated with increased risk for death from suicide among men. Finally, high total cholesterol levels were associated with increased risk for death from suicide among women. Conclusions: Sociodemographic factors, health behaviors, and biological indicators were associated with risk of death from suicide among young adults. The main limitation of our study is that we did not have data on family history of suicide or previous experience of suicidal attempts. Future studies that elucidate the mechanisms behind the risk elevating effect of such factors are needed to further validate the findings from our study. Funding Statement: This study was supported by the Ministry of Health and Welfare of Korea (Grant No: 20170322652-00). Declaration of Interests: The authors of this paper, Yoosun Cho, Seulggie Choi, Kyuwoong Kim, and Sang Min Park, declare that we have no conflict of interest. Ethics Approval Statement: This study was approved by the Seoul National University Hospital Institutional Review Board (IRB number: 1703-039-836) and the requirement for informed consent was waived as the NHIS database is anonymized according to strict confidentiality guidelines.

Effects of childhood trauma on cortisol levels in suicide attempters and ideators

ObjectivesSuicide is a global health issue. Dysregulated hypothalamic-pituitary-adrenal (HPA) axis activity, as measured by cortisol levels, has been identified as one potential risk factor for suicide. Recent evidence has indicated that blunted cortisol reactivity to stress is associated with suicidal behavior. The current study investigated whether childhood trauma was associated with blunted cortisol reactivity to a laboratory stressor and resting cortisol levels in suicide attempters and ideators. Methods160 Participants were recruited and grouped according to history of previous suicidal attempt, suicidal ideation or as control participants. Participants completed background questionnaires, including the Childhood Trauma Questionnaire, before completing a laboratory stress task. Cortisol levels were assessed at rest and during the stress task. ResultsThe highest levels of childhood trauma were reported in those who had attempted suicide (78.7%), followed by those who thought about suicide (37.7%) and then those with no suicidal history (17.8%). Moreover, regression analyses showed that childhood trauma was a significant predictor of blunted cortisol reactivity to stress and resting cortisol levels, such that higher levels of trauma were associated with lower cortisol levels in those with a suicidal history. Family history of suicide did not interact with the effects of childhood trauma on cortisol levels. ConclusionsThese results indicate that childhood trauma is associated with blunted HPA axis activity in vulnerable populations in adulthood. The challenge for researchers is to elucidate the precise causal mechanisms linking trauma, cortisol and suicide risk and to investigate whether the effects of childhood trauma on cortisol levels are amendable to psychological intervention.

Which Posttraumatic Stress Disorder Symptoms, Trauma Types, and Substances Correlate With Suicide Attempts in Trauma Survivors?

To examine among trauma survivors several potential suicide risk factors, some of which have never been studied in this population (eg, DSM-5 posttraumatic stress disorder [PTSD] symptoms, benzodiazepines). Using a cross-sectional self-report survey methodology in a consecutive sample of adult outpatients with trauma (N = 480), we examined relationships between suicide attempts and demographics, trauma types, PTSD symptoms, substance-related problems, and benzodiazepine prescriptions. The study was conducted from October 2014 to February 2015. PTSD diagnosis was significantly correlated with suicide attempt prevalence (adjusted odds ratio [AOR] = 2.6) and was the variable most strongly associated with the number of attempts among participants with at least 1 suicide attempt. PTSD symptom severities (total, cluster, and all but 3 individual symptoms) significantly correlated with attempted suicide; recklessness (AOR = 1.7), anhedonia (AOR = 1.7), and negative beliefs (AOR = 1.6) were most strongly correlated. Mood/cognitive alterations-a cluster new to the DSM-5-were particularly associated with suicide attempts (AOR = 3.2). Childhood maltreatment was strongly associated with attempted suicide; childhood physical abuse (AOR = 2.9) was the only trauma type significantly correlated with suicide attempts after adjustment for multiple testing. Attempted suicide was significantly correlated with substance-related problems in general (AOR = 2.6) and alcohol specifically (AOR = 2.9). As predicted, suicide attempts correlated with PTSD symptom severity, childhood maltreatment, and substance-related problems. Our hypothesized correlation between suicide and benzodiazepine prescriptions was in part explained by PTSD symptom severity.

Suicide risk assessment in the elderly

ObjectivesTo assess suicide risk in elderly psychiatric outpatients and to identify potential suicide risk factors in this population.MethodsThis was a cross-sectional, descriptive and analytical study, including 50 psychiatric outpatients, aged 65 years or more and attending the Hédi Chaker University Hospital, in Sfax (Tunisia), between November and December 2015. We used a hetero questionnaire including epidemiological and clinical data and three scales: the Suicidal Risk Assessment Scale of Ducher (RSD), the Hospital Anxiety and Depression Scale (HADS) and the Mini Mental State Examination (MMSE).ResultsThe sex ratio (M/F) was 1. The average age of patients was 68.62 years. The majority of them were married (68%), unemployed (98%), living in urban area (58%) and within their family (88%); they had at most a primary degree (80%) and a low socioeconomic level (74%).The prevalence of patients at risk of suicide (RSD ≥ 3) was 26%. This risk was high (RSD ≥ 7) in 18% of cases.The presence of suicidal ideation (RSD ≥ 3) was correlated with: a family history of suicide attempt (58.3% vs. 15.8%; P = 0.003), a personal history of suicide attempt (80% vs. 12.5%; P &lt; 0.001), depressive symptoms (HAD-D ≥ 11) (36.7% vs. 10%; P = 0.05) and anxiety (HAD-A ≥ 11) (52.4% vs. 6.9%; P = 0.001).ConclusionOur study showed that among older psychiatric outpatients, one in four had suicidal thoughts. This high rate encourages us to search systematically these suicidal thoughts in this population, especially in patients with risk factors such as a family history of suicide attempt, depressive or anxious symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Indigenous Adolescents' Suicidal Behaviors and Risk Factors: Evidence from the National Youth Risk Behavior Survey.

The study sought to examine indigenous adolescents' suicidal behaviors and risk factors in a nationally representative sample and explore potential causes of disparities. The study analyzed the 1991-2013 Youth Risk Behavior Survey National Combined Datasets. Suicidal behavior outcomes included suicide consideration, planning, and attempts during the past 12months. Logit regressions were used to estimate the effects of potential suicide risk factors on these suicidal behaviors. The results showed that a high percentage of indigenous adolescents exhibited suicidal behaviors (consideration: 24.6%; planning: 20.7%; attempts: 16.2%). After adjusting for risk factors, indigenous adolescents were no more likely than other adolescents to consider or plan for suicide (consideration: OR 1.18, CI 0.96-1.45, p=0.125; planning: OR 1.16, CI 0.95-1.42, p=0.156); however, they remained significantly more likely to have made suicide attempts (OR 1.73, CI 1.32-2.26, p<0.001). Disparities in adolescent suicidal behaviors could be explained by the heterogeneous prevalence of suicidal risk factors across different races/ethnicities.

The Association Between Masculinity and Nonsuicidal Self-Injury.

Several known risk factors for nonsuicidal self-injury (NSSI), such as negative emotionality and deficits in emotion skills, are also associated with masculinity. Researchers and clinicians suggest that masculine norms around emotional control and self-reliance may make men more likely to engage in self-harm. Masculinity has also been implicated as a potential risk factor for suicide and other self-damaging behaviors. However, the association between masculinity and NSSI has yet to be explored. In the current study, a sample of 912 emerging adults from two universities in the Northeastern United States completed a web-based questionnaire assessing adherence to masculine norms, engagement in NSSI, and known risk factors for NSSI (demographics and number of self-injurers known). Stronger adherence to masculine norms predicted chronic NSSI (five or more episodes throughout the life span) above and beyond other known risk factors. Adherence to masculine norms was related to methods of NSSI. Clinical implications are discussed, including discussions of masculine norms in treatment settings. Future research should examine what specific masculine norms are most closely linked to NSSI and other self-damaging behaviors.

A Qualitative Study of Potential Suicide Risk Factors Among Operation Iraqi Freedom/Operation Enduring Freedom Soldiers Returning to the Continental United States (CONUS).

A qualitative study among Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Soldiers was conducted to explore potential constructs underlying suicide according to the interpersonal-psychological theory of suicide (IPTS); these include burdensomeness, failed belonging, and acquired capability. Qualitative semistructured interviews were conducted with 68 Soldiers at 3 months post-OEF/OIF deployment. Soldiers were asked about changes in their experiences of pain, burdensomeness, and lack of belonging. The methodology employed was descriptive phenomenological. Transcripts were reviewed and themes related to the IPTS constructs emerged. Soldiers' postdeployment transition experiences included higher pain tolerance, chronic pain, emotional reactivity, emotional numbing and distancing, changes in physical functioning, combat guilt, discomfort with care seeking, and difficulties reintegrating into family and society. Findings highlight the utility of the IPTS in understanding precursors to suicide associated with transition from deployment, as well as treatment strategies that may reduce risk in Soldiers during reintegration.

Suicide in first episode psychosis: A nationwide cohort study

BackgroundRelatively little is known about suicide in diagnostic subtypes of first episode psychosis (FEP). Our aim was to assess suicide rates and potential risk factors for suicide in FEP. MethodsThis is a national register-based cohort study of patients born in 1973–1978 in Sweden and who were hospitalized with a FEP between ages 15 and 30years (n=2819). The patients were followed from date of discharge until death, emigration, or 31st of December 2008. The suicide rates for six diagnostic subtypes of FEP were calculated. Suicide incidence rate ratios (IRRs) were calculated to evaluate the association between suicide and psychiatric, familial, social, and demographic factors. ResultsIn total 121 patients died by suicide. The overall suicide rate was 4.3 (95% confidence interval [CI] 3.5–5.0) per 1000person-years. The highest suicide rates were found in depressive disorder with psychotic symptoms and in delusional disorder. In an adjusted model, the strongest risk factors for suicide were self-harm (IRR 2.7, CI 1.7–4.4) or a conviction for violent crime (IRR 2.0, CI 1.3–3.2). Also having a first-degree relative with a schizophrenia/bipolar diagnosis (IRR 2.1, CI 1.2–3.6) or substance use disorder (IRR 2.0, CI 1.2–3.2) were significant risk factors for suicide. ConclusionsImpulsive behavior such as self-harm as well as having a family history of severe mental disorder or substance use are important risk factors for suicide in FEP.

A Qualitative Description of Female Veterans’ Deployment‐Related Experiences and Potential Suicide Risk Factors

A qualitative study among female Veterans from recent conflicts was conducted to explore the women's experiences and potential suicide risk factors according to the Interpersonal Psychological Theory of Suicide, including burdensomeness, failed belongingness, and acquired ability. The presented paper is an extension of published work by Brenner et al. (2008) regarding mostly male combat Veterans. The methodology employed was qualitative descriptive with hermeneutic hues (Sandelowski, 2000). Interviews were conducted with 19 women, aged 24-52 years, all of whom had been deployed to combat zones in Iraq and/or Afghanistan. Transcripts were reviewed and themes emerged regarding women being a minority within their environment and deployment-related stressors. These experiences seemed to influence participants' views of the world and ways of coping. Among the interviewed female Veterans, preliminary support was provided for Joiner's concepts. Therapeutic strategies for applying themes to clinical practice (e.g., peer support, family therapy, interventions aimed at increasing distress tolerance) are provided.