Wednesday, September 01, 2021

New research in American Journal of Psychiatry identifies risk factors for suicide attempt among soldiers


Peer-Reviewed Publication

AMERICAN PSYCHIATRIC ASSOCIATION

New research in the American Journal of Psychiatry identifies factors that may help assess suicide risk in soldiers. According to the study, Predictors of Suicide Attempt Within 30 Days After First Medically Documented Suicidal Ideation in U.S. Army Soldiers, suicide risk was highest within 30 days after ideation diagnosis and was more likely among women and combat medics.   

“This Suicide Prevention Month, it’s important to remember that research can help us better understand risk factors and which populations are more vulnerable,” said APA President Vivian Pender, M.D.  “It is also a reminder that we can all play a role in preventing suicide by learning to recognize signs of distress and reaching out to connect anyone at risk with help.”

The authors examined risk factors for suicide attempt within the first month after a diagnosis of suicidal ideation, looking at sociodemographic and service-related characteristics, psychiatric diagnoses, physical health care visits, injuries, and others. Using data from the Army Study to Assess Risk and Resilience in Servicemembers, the researchers reviewed records from more than 11,000 active duty enlisted soldiers with documented suicidal ideation and no prior documented suicide attempts.

About half (52.7%) of the solders identified with suicide ideation were in their first two years of service and 57.7% had never deployed. About 80% had had at least one outpatient visit in the previous two months. The most common psychiatric diagnoses were depression and related disorders, tobacco use disorder, anxiety disorder and adjustment disorder.  
 

In the study, 7.4% soldiers with suicidal ideation subsequently attempted suicide. Almost half of the attempts, 3.5%, occurred within 30 days after suicidal ideation. The risk for suicide attempt was highest on the first day after suicidal ideation diagnosis and decreased over time.

 

The study found that females, combat medics, individuals with an anxiety disorder diagnosis prior to suicidal ideation, and those diagnosed with a sleep disorder on the same day as the suicidal ideation were more likely to attempt suicide within 30 days.

"Identifying suicide risk in the population, in patients in primary care, and in patients in psychiatric care who frequently have suicide ideation, are all challenging and different questions,” said Robert J. Ursano, M.D., one of the study authors and Director, Center for the Study of Traumatic Stress, Uniformed Services University. “This paper importantly speaks to psychiatrists and other mental health care providers who have to make difficult treatment and management decisions for those specifically struggling with suicide ideation."

While depression-related diagnoses were common among the soldiers with suicide ideation, they were not associated with an increased risk of suicide attempt during the first month. Major depression was diagnosed in 24% of soldiers with suicide ideation and depression-related diagnoses (such as dysthymic disorder and adjustment disorder with depressed mood) were diagnosed in nearly 60% of soldiers on the same day suicide ideation was diagnosed. A diagnosis of posttraumatic stress disorder was also not associated with an increased risk of suicide attempt within 30 days. 

 

     National Suicide Prevention Lifeline                   Crisis Textline
     800-273-8255 or Chat with Lifeline                    Text TALK to 741741                             


More information

See also two recent articles on suicide risk published in the APA journal Psychiatric Services:

More information is available in curated collections of Psychiatric Services articles on:


American Psychiatric Association
The American Psychiatric Association, founded in 1844, is the oldest medical association in the country. The APA is also the largest psychiatric association in the world with 37,400 physician members specializing in the diagnosis, treatment, prevention and research of mental illnesses. APA’s vision is to ensure access to quality psychiatric diagnosis and treatment. For more information, please visit www.psychiatry.org.

JOURNAL

American Journal of Psychiatry

DOI

10.1176/appi.ajp.2021.20111570 

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Predictors of Suicide Attempt Within 30 Days After First Medically Documented Suicidal Ideation in U.S. Army Soldiers

ARTICLE PUBLICATION DATE

1-Sep-2021

COI STATEMENT

Dr. Kessler has received support for epidemiological studies from SanofiAventis; he has served as a consultant for DataStat, Holmusk, Johnson & Johnson Wellness and Prevention, RallyPoint Networks, Sage Pharmaceuticals, Shire, and Takeda and on advisory boards for Johnson & Johnson Services Lake Nona Life Project; and he has stock options in Mirah, PYM, and Roga Sciences. Dr. Stein has received research support from the Department of Defense, the Department of Veterans Affairs, and NIH; he has served as a consultant for Actelion, Acadia Pharmaceuticals, Aptinyx, ATAI Life Sciences, Boehringer Ingelheim, Bionomics, BioXcel Therapeutics, Clexio, EmpowerPharm, Engrail Therapeutics, GW Pharmaceuticals, Janssen, Jazz Pharmaceuticals, and Roche/Genentech and on scientific advisory boards for the Anxiety and Depression Association of America and the Brain and Behavior Research Foundation; he receives remuneration for his editorial work on Depression and Anxiety (Editor-in-Chief), Biological Psychiatry (Deputy Editor), and UpToDate (Co-Editor-in-Chief for Psychiatry); and he has stock options in Epivario and Oxeia Biopharmaceuticals. The other authors report no financial relationships with commercial interests

Unmarried adults with heart disease living in rural areas face more hopelessness, increased risk of death

Journal of the American Heart Association Report

Peer-Reviewed Publication

AMERICAN HEART ASSOCIATION

Embargoed until 4 a.m. CT/5 a.m. ET Wednesday, Sept. 1, 2021

DALLAS, Sept. 1, 2021 — Living in a rural setting and being unmarried were each linked to higher rates of hopelessness among people with heart disease, according to new research published today in the Journal of the American Heart Association, an open access journal of the American Heart Association.

The study is the first to explore whether living in a rural setting is a significant risk factor for hopelessness. National statistics indicate U.S. adults – those with and without cardiovascular disease – who live in rural areas have higher rates of death than those who live in urban communities. Many known risk factors for heart disease – high blood pressure, obesity, cigarette smoking and low levels of physical activity – are also more prevalent among people who live in rural settings.

Feelings of hopelessness, whether it’s a temporary response to a new event (a state), or an ongoing outlook toward life (a trait), are also linked to the progression and development of heart disease. Up to half of people with heart disease report hopeless feelings, and hopelessness can more than triple the risk of death or heart attack. And, while living in a rural area and hopelessness are each linked to heart disease, this study is the first to examine whether living in a rural setting affects hopelessness.

“That is what makes our findings so surprising,” said the study’s senior author Susan L. Dunn, Ph.D., R.N., FAHA, an associate professor and department head in the department of biobehavioral nursing science at the University of Illinois in Chicago. “We found that living in a rural area is a risk factor for hopelessness. Because we know hopelessness is predictive of death in people with heart disease, health care professionals need to recognize the subgroups who are most at risk and provide guidance and treatment.”

Researchers collected data from 628 adults at two hospitals in South Dakota and one hospital in Michigan. Participants were 18 years or older and had been diagnosed with a heart attack or severe chest pains (angina) or had undergone procedures to open clogged heart arteries (surgery or stent). About 25% of the study’s participants lived in a rural area. Overall, roughly one-third were women; about two-thirds were married and most (92%) were white. About half of the participants had a history of cardiovascular disease, and one-fourth suffered from depression.

Researchers used the State-Trait Hopelessness Scale, a self-reported questionnaire measuring a negative outlook and sense of helplessness toward the future, with higher scores equating to increased feelings of hopelessness.

Because hopelessness and depression are often associated yet distinctly different, participants also completed a questionnaire to measure the severity of their depression. In addition, decreased physical function is linked to feelings of hopelessness, so participants completed another questionnaire to gauge their ability to perform daily physical activities. Finally, researchers categorized where participants’ lived using census tract-based data.

Researchers found:

  • Levels of state hopelessness (sparked by a new life event, such as a heart event) in adults with heart disease living in rural areas were 10% higher than among urban adults (58.8% to 48.8%, respectively).
  • Levels of trait hopelessness (overall outlook on life) were relatively similar among rural and urban adults (59% to 55%, respectively).
  • 20% more unmarried participants in rural areas experienced state hopelessness than their married, rural counterparts.

The authors suggest additional research is needed to assess whether adults with heart disease living in rural areas continue to have higher levels of state hopelessness than those who live in urban areas after hospital discharge and throughout their recovery. The connection between marital status among people living in rural areas to feelings of hopelessness is also important for future studies.

The study also has several important limitations. The sample size was small and included people living in the Great Lakes and the Great Plains regions, so more research is needed to examine rural and urban differences in various geographic regions throughout the U.S. and in the rest of the world. There was also limited racial and ethnic diversity among participants in the study, and unmarried partners who lived together were not specifically categorized.

“These results indicate that we need more information, and there is a need to develop effective prevention and treatment methods for people with heart disease who have feelings of hopelessness,” Dunn said.

###

Co-authors are Deb Bomgaars, Ph.D., R.N., C.N.E.; Gwenneth A. Jensen, Ph.D., R.N., C.N.S.; Lynn L. White, Ph.D., R.N., A.C.N.S.-B.C.; Kristin M. Van De Griend, Ph.D., M.P.H.; Angela K. Visser, M.S.; Madison P. Goodyke, B.S.N., R.N.; Anna Luong, B.S.N., R.N.; and Nathan L. Tintle, Ph.D. Authors’ disclosures are listed in the manuscript.

The study was funded by the Dordt University Office for Research and Scholarship.

Additional Resources:

Statements and conclusions of studies published in the American Heart Association’s scientific journals are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. The Association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and biotech companies, device manufacturers and health insurance providers and the Association’s overall financial information are available here. 

About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. We are dedicated to ensuring equitable health in all communities. Through collaboration with numerous organizations, and powered by millions of volunteers, we fund innovative research, advocate for the public’s health and share lifesaving resources. The Dallas-based organization has been a leading source of health information for nearly a century. Connect with us on heart.org, Facebook, Twitter or by calling 1-800-AHA-USA1.

JOURNAL

Journal of the American Heart Association

ARTICLE TITLE

Investigating Rurality as a Risk Factor for State and Trait Hopelessness in Hospitalized Patients with Ischemic Heart Disease

ARTICLE PUBLICATION DATE

1-Sep-2021


Posted by at

No comments:

Post a Comment

Subscribe to: Post Comments (Atom)