Risk for suicidal behaviors associated with PTSD, depression, and their comorbidity in the U.S. Army.
BACKGROUND
Suicide rates have risen considerably in the United States Army in the past decade. Suicide risk is highest among those with past suicidality (suicidal ideation or attempts). The incidence of posttraumatic stress disorder (PTSD) and depressive illnesses has risen concurrently in the U.S. Army. We examined the relationship of PTSD and depression, independently and in combination, and rates of past-year suicidality in a representative sample of U.S. Army soldiers.


METHODS
This study used the DoD Survey of Health Related Behaviors Among Active Duty Military Personnel (DoD HRB) (N=5927). Probable PTSD and depression were assessed with the PTSD Checklist (PCL) and the 10-item short form of the Center for Epidemiologic Studies Depression Scale (CES-D), respectively. Past-year suicidality was assessed via self-report.


RESULTS
Six percent of Army service members reported suicidality within the past year. PTSD and MDD were each independently associated with past-year suicidality. Soldiers with both disorders were almost three times more likely to report suicidality within the past year than those with either diagnosis alone. Population-attributable risk proportions for PTSD, depression, and both disorders together were 24%, 29%, and 45%, respectively.


LIMITATIONS
The current study is subject to the limitations of a cross-sectional survey design and the self-report nature of the instruments used.


CONCLUSIONS
PTSD and depression are each associated with suicidality independently and in combination in the active duty component of the U.S. Army. Soldiers presenting with either but especially both disorders may require additional outreach and screening to decrease suicidal ideation and attempts.
['Ramsawh|Holly J|HJ|', 'Fullerton|Carol S|CS|', 'Mash|Holly B Herberman|HB|', 'Ng|Tsz Hin H|TH|', 'Kessler|Ronald C|RC|', 'Stein|Murray B|MB|', 'Ursano|Robert J|RJ|']
D000293:Adolescent D000328:Adult D003430:Cross-Sectional Studies D003863:Depression D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D008889:Military Personnel D012306:Risk D013313:Stress Disorders, Post-Traumatic D059020:Suicidal Ideation D013405:Suicide D014481:United States D055815:Young Adult
Depression Suicidal ideation Attempted Stress disorders Military personnel Post-traumatic