@article{49bca7d75cc348bfab916a5fdac8459c,
title = "Suicide attempts and mental health diagnoses in combat-injured service members: A retrospective cohort study",
abstract = "Introduction: Examinations of risk factors for suicide attempt in United States service members at high risk of mental health diagnoses, such as those with combat injuries, are essential to guiding prevention and intervention efforts. Methods: Retrospective cohort study of 8727 combat-injured patients matched to deployed, non-injured patients utilizing Department of Defense and Veterans Affairs administrative records. Results: Combat injury was positively associated with suicide attempt in the univariate model (HR = 1.75, 95% CI 1.5–2.1), but lost significance after adjustment for mental health diagnoses. Utilizing Latent Transition Analysis in the combat-injured group, we identified five mental/behavioral health profiles: (1) Few mental health diagnoses, (2) PTSD and depressive disorders, (3) Adjustment disorder, (4) Multiple mental health comorbidities, and (5) Multiple mental health comorbidities with alcohol use disorder (AUD). Multiple mental health comorbidities with AUD had the highest suicide attempt rate throughout the study and more than four times that of Multiple mental health comorbidities in the first study year (23.4 vs. 5.1 per 1000 person years, respectively). Conclusion: Findings indicate that (1) combat injury's impact on suicide attempt is attenuated by mental health and (2) AUD with multiple mental health comorbidities confers heightened suicide attempt risk in combat-injured service members.",
keywords = "military & veterans, suicide attempt, trauma",
author = "Walker, {Lauren E.} and Eduard Poltavskiy and Howard, {Jeffrey T.} and Janak, {Jud C.} and Jessica Watrous and Karl Alcover and Pettey, {Warren B.P.} and Shiva Ambardar and Eric Meyer and Gundlapalli, {Adi V.} and Stewart, {Ian J.}",
note = "Funding Information: The authors would like to gratefully acknowledge the staff of the Department of Defense Trauma Registry, the Defense Health Agency, the Defense Suicide Prevention Office (DSPO), the VA Informatics and Computing Infrastructure (VINCI), the VA/DoD Identity Repository (VADIR), and the Department of Veterans Affairs for providing data for this study. This study was funded by the United States Air Force Headquarters, Office of the Surgeon General and supported by VA Center of Innovation Award #I50HX001240 from the Health Services Research and Development of the Office of Research and Development of the US Department of Veterans Affairs. Funding Information: The authors would like to gratefully acknowledge the staff of the Department of Defense Trauma Registry, the Defense Health Agency, the Defense Suicide Prevention Office (DSPO), the VA Informatics and Computing Infrastructure (VINCI), the VA/DoD Identity Repository (VADIR), and the Department of Veterans Affairs for providing data for this study. This study was funded by the United States Air Force Headquarters, Office of the Surgeon General and supported by VA Center of Innovation Award #I50HX001240 from the Health Services Research and Development of the Office of Research and Development of the US Department of Veterans Affairs. Publisher Copyright: {\textcopyright} 2022 American Association of Suicidology. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.",
year = "2023",
month = apr,
doi = "10.1111/sltb.12938",
language = "English",
volume = "53",
pages = "227--240",
journal = "Suicide and Life-Threatening Behavior",
issn = "0363-0234",
number = "2",
}