Posttraumatic stress disorder as a risk factor for suicidal ideation in Iraq and Afghanistan War veterans

Abstract

Posttraumatic stress disorder (PTSD) was examined as a risk factor for suicidal ideation in Iraq and Afghanistan War veterans (N = 407) referred to Veterans Affairs mental health care. The authors also examined if risk for suicidal ideation was increased by the presence of comorbid mental disorders in veterans with PTSD. Veterans who screened positive for PTSD were more than 4 times as likely to endorse suicidal ideation relative to non-PTSD veterans. Among veterans who screened positive for PTSD (n = 202), the risk for suicidal ideation was 5.7 times greater in veterans who screened positive for two or more comorbid disorders relative to veterans with PTSD only. Findings are relevant to identifying risk for suicide behaviors in Iraq and Afghanistan War veterans.

The factor structure of psychiatric comorbidity among Iraq/Afghanistan-era veterans and its relationship to violence, incarceration, suicide attempts, and suicidality

“…This finding is consistent with our hypotheses, which were based on prior research that suggested that comorbid substance-use disorders added relatively little incremental risk for suicidality over and above PTSD among veterans (Jakupcak et al, 2009;Guerra et al, 2011). While additional research is needed to replicate and expand upon these findings, our results suggest that the distress factor (i.e., PTSD and depression) of psychiatric comorbidity may be a significant risk factor for both suicidality and violence among returning Iraq/Afghanistan veterans and could help to explain the cooccurrence of these important outcomes.…”

“…Given prior research demonstrating that the distress factor is predictive of suicide attempts (Eaton et al, 2013) as well prior research indicating that veterans with both PTSD and alcohol-use disorders may not endorse greater suicidality than veterans with PTSD alone (Guerra et al, 2009;Jakupcak et al, 2009), we hypothesized that current suicidality and history of suicide attempts would be most strongly associated with the distress factor of psychiatric comorbidity.…”

Risk for suicidal behaviors associated with PTSD, depression, and their comorbidity in the U.S. Army

“…Having both PTSD and depression were associated with a significantly greater risk of past-year suicidality than having either PTSD or depression alone. This finding is consistent with prior studies which have also found an increased risk associated with PTSD and comorbid psychiatric disorders, including depression, relative to PTSD alone (Calabrese et al, 2011;Cougle et al, 2009;Jakupcak et al, 2009). The interaction between PTSD and depression was not significant in the current analysis on either multiplicative or additive scales.…”

Reducing Barriers to Mental Health and Social Services for Iraq and Afghanistan Veterans: Outcomes of an Integrated Primary Care Clinic

“…The prevalence of mental health disorders has steadily increased: between 18.5% and 42% of OEF/OIF veterans are estimated to suffer from deployment-related mental health problems [2][3][4] . Further, mental health diagnoses in this population are typically comorbid with other mental and physical disorders [5][6][7][8] , resulting in a significant public health burden [9][10][11][12] . Despite population-based mental health screening by the military and VA 13 , most OEF/OIF veterans with mental health problems, including posttraumatic stress disorder (PTSD), do not access or receive an adequate course of mental health treatment 3,4,14,15 .…”