Suicide: A National Health Challenge, An Army Health Threat

Ursano, Robert J.

doi:10.1521/psyc.2013.76.2.95

“…Moreover, death by suicide recently surpassed combat casualty as the most frequent cause of death among active-duty Servicemembers [Center 2014]. Though suicide rates in the US Army have historically been lower than in the general population, this trend has changed in recent years [Anglemyer et al 2016] leading to intensive suicide prevention efforts [Engel 2013; Ursano 2013]. …”

Section: Introductionmentioning

confidence: 99%

Genomewide association studies of suicide attempts in US soldiers

Stein

¹

,

Ware

²

,

Mitchell

³

et al. 2017

American J of Med Genetics Pt B

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Suicide is a global public health problem with particular resonance for the U.S. military. Genetic risk factors for suicidality are of interest as indicators of susceptibility and potential targets for intervention. We utilized population-based nonclinical cohorts of US military personnel (discovery: N = 473 cases and N = 9778 control subjects; replication: N = 135 cases and N = 6879 control subjects) and a clinical case-control sample of recent suicide attempters (N = 51 cases and N = 112 control subjects) to conduct GWAS of suicide attempts (SA). Genomewide association was evaluated within each ancestral group (European-, African-, Latino-American) and study using logistic regression models. Meta-analysis of the European ancestry discovery samples revealed a genomewide significant locus in association with SA near MRAP2 (melanocortin 2 receptor accessory protein 2) and CEP162 (centrosomal protein 162); 12 genomewide significant SNPs in the region; peak SNP rs12524136-T, OR=2.88, p=5.24E-10. These findings were not replicated in the European ancestry subsamples of the replication or suicide attempters samples. However, the association of the peak SNP remained significant in a meta-analysis of all studies and ancestral subgroups (OR = 2.18, 95%CI 1.70, 2.80). Polygenic risk score (PRS) analyses showed some association of SA with bipolar disorder. The association with SNPs encompassing MRAP2, a gene expressed in brain and adrenal cortex and involved in neural control of energy homeostasis, points to this locus as a plausible susceptibility gene for suicidality that should be further studied. Larger sample sizes will be needed to confirm and extend these findings.

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“…The past decade of armed conflict in Afghanistan and Iraq has been associated with increased rates of suicidal behaviour, including suicidal ideation, plans, and attempts, in US military personnel. [1][2][3][4][5][6] Findings from other nations have been less dramatic-perhaps related to smaller military populations hence greater difficulty detecting significant trends for rare events like suicide-but Canada, at least, may now be seeing similar patterns. [7] Several studies have pointed to a greater risk of suicidality in modern veterans-a finding not detected in veterans of earlier conflicts.…”

Section: Introductionmentioning

confidence: 99%

Insomnia, psychiatric disorders and suicidal ideation in a national representative sample of active Canadian Forces members

Richardson¹,

Thompson²,

King³

et al. 2021

Preprint

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Background Past research on the association between insomnia and suicidal ideation (SI) has produced mixed findings. The current study explored the relationship between insomnia, SI, and past-year mental health status among a large Canadian Forces (CF) sample. Method Data was obtained from the 2013 Canadian Forces Mental Health Survey (CFMHS), and included a large representative sample of Canadian Regular Forces personnel (N = 6700). A series of univariate logistic regressions were conducted to test individual associations between past-year mental health status, insomnia, and potential confounds and SI. Mental health status included three groups: 0, 1, or two or more probable diagnoses of posttraumatic stress disorder (PTSD), major depressive disorder (MDD), generalized anxiety disorder (GAD), panic disorder (PD) and alcohol abuse/dependence. Stepwise multivariate logistic regression was used to assess the relationship between insomnia and SI with mental health status as a moderator. Results 40.8% of respondents reported experiencing insomnia. Both insomnia and number of mental health conditions incrementally increased the risk of SI. However, past-year mental health status was a significant moderator of this relationship, such that for CF personnel with either no (AOR = 1.61, 1.37–1.89) or only one past-year mental health condition (AOR = 1.39, 1.12–1.73), an incremental increase in insomnia was associated with an increased likelihood of SI. However, in personnel with two or more past-year mental health disorders, insomnia was no longer significantly associated with SI (AOR = 1.04, 0.81–1.33). Conclusions Insomnia significantly increased the odds of SI, but only among individuals with no or one mental health condition. Findings highlight the importance of assessing insomnia among CF members in order to further suicide prevention efforts.

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“…Given a recent increase in reported rates of suicide among military members, [1][2][3][4][5][6]43] coupled with the few studies on insomnia and suicide in military members as opposed to other populations currently available, the authors of the current study hypothesize that insomnia does contribute to SI amongst military personnel, and that an interactive effect between insomnia and mental health conditions such as PTSD may exist.. The current paper used data from a 2013 population-based mental health survey of serving Canadian military personnel to explore: 1) The contribution of insomnia towards SI while controlling for common mental disorders; and 2) The possibility of interactions between insomnia and mental disorders with respect to SI.…”

Section: Introductionmentioning

confidence: 99%

Insomnia, psychiatric disorders and suicidal ideation in a national representative sample of active Canadian Forces members

Richardson¹,

Thompson²,

King³

et al. 2021

Preprint

0

View full text Add to dashboard Cite

Background Past research on the association between insomnia and suicidal ideation (SI) has produced mixed findings. The current study explored the relationship between insomnia, SI, and past-year mental health status among a large Canadian Forces (CF) sample. Method Data was obtained from the 2013 Canadian Forces Mental Health Survey (CFMHS), and included a large representative sample of Canadian Regular Forces personnel (N = 6700). A series of univariate logistic regressions were conducted to test individual associations between past-year mental health status, insomnia, and potential confounds and SI. Mental health status included three groups: 0, 1, or two or more probable diagnoses of posttraumatic stress disorder (PTSD), major depressive disorder (MDD), generalized anxiety disorder (GAD), panic disorder (PD) and alcohol abuse/dependence. Stepwise multivariate logistic regression was used to assess the relationship between insomnia and SI with mental health status as a moderator. Results 40.8% of respondents reported experiencing insomnia. Both insomnia and number of mental health conditions incrementally increased the risk of SI. However, past-year mental health status was a significant moderator of this relationship, such that for CF personnel with either no (AOR = 1.61, 1.37–1.89) or only one past-year mental health condition (AOR = 1.39, 1.12–1.73), an incremental increase in insomnia was associated with an increased likelihood of SI. However, in personnel with two or more past-year mental health disorders, insomnia was no longer significantly associated with SI (AOR = 1.04, 0.81–1.33). Conclusions Insomnia significantly increased the odds of SI, but only among individuals with no or one mental health condition. Findings highlight the importance of assessing insomnia among CF members in order to further suicide prevention efforts.

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Suicide: A National Health Challenge, An Army Health Threat

Cited by 7 publications

References 5 publications

Genomewide association studies of suicide attempts in US soldiers

Genomewide association studies of suicide attempts in US soldiers

Insomnia, psychiatric disorders and suicidal ideation in a national representative sample of active Canadian Forces members

Insomnia, psychiatric disorders and suicidal ideation in a national representative sample of active Canadian Forces members

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