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Significant controversy exists as to whether soldiers are at increased risk for suicide and suicidal behaviors compared with civilians. Furthermore, little is known about whether risk factors for suicidal behaviors in civilian populations are generalizable to soldiers. The aim of the current study is to determine whether the prevalence and correlates of past-year suicidal ideation and suicide attempts differ in Canadian soldiers when compared with Canadian civilians. The current study utilized data from the Canadian Community Health Survey Cycle 1.2-Canadian Forces Supplement in conjunction with the 2001-2002 Canadian Community Health Survey Cycle 1.2. Logistic regression interaction models were used to explore differences between correlates of suicidal ideation and suicide attempts comparing Canadian soldiers with civilians. Although there was no significant difference between the 2 samples on prevalence of past-year suicidal ideation, the prevalence of past-year suicide attempts was significantly lower in the Canadian forces sample compared with the civilian population (odds ratio = 0.41, 95% confidence interval: 0.25, 0.67). Findings suggest that suicide attempts are less common in Canadian active military personnel than in the civilian population. Possible mechanisms for these differences are discussed.

Background: Previous work has suggested that anxiety disorders are associated with suicide attempts. However, many studies have been limited by lack of accounting for factors that could influence this relationship, notably personality disorders. This study aims to examine the relationship between anxiety disorders and suicide attempts, accounting for important comorbidities, in a large nationally representative sample., Methods: Data came from the National Epidemiologic Survey on Alcohol and Related Conditions Wave 2. Face-to-face interviews were conducted with 34,653 adults between 2004 and 2005 in the United States. The relationship between suicide attempts and anxiety disorders (panic disorder, agoraphobia, social phobia, specific phobia, generalized anxiety disorder, posttraumatic stress disorder (PTSD)) was explored using multivariate regression models controlling for sociodemographics, Axis I and Axis II disorders., Results: Among individuals reporting a lifetime history of suicide attempt, over 70% had an anxiety disorder. Even after adjusting for sociodemographic factors, Axis I and Axis II disorders, the presence of an anxiety disorder was significantly associated with having made a suicide attempt (AOR=1.70, 95% confidence interval (CI): 1.40-2.08). Panic disorder (AOR=1.31, 95% CI: 1.06-1.61) and PTSD (AOR=1.81, 95% CI: 1.45-2.26) were independently associated with suicide attempts in multivariate models. Comorbidity of personality disorders with panic disorder (AOR=5.76, 95% CI: 4.58-7.25) and with PTSD (AOR=6.90, 95% CI: 5.41-8.79) demonstrated much stronger associations with suicide attempts over either disorder alone., Conclusion: Anxiety disorders, especially panic disorder and PTSD, are independently associated with suicide attempts. Clinicians need to assess suicidal behavior among patients presenting with anxiety problems., ((c) 2010 Wiley-Liss, Inc.)

Objective: To determine whether exposure to particular types of traumatic events was differentially associated with suicide attempts in a representative sample of active military personnel., Method: Data came from the Canadian Community Health Survey: Mental Health and Well-Being Canadian Forces Supplement (CCHS-CFS), a cross-sectional survey that provided a comprehensive examination of mental disorders, health, and the well-being of currently active Canadian military personnel (n = 8441; aged 16 to 54 years; response rate 81.1%). Respondents were asked about exposure to 28 traumatic events that occurred during their lifetime. Suicide attempts were measured using a question about whether the person ever "attempted suicide or tried to take [his or her] own life.", Results: The prevalence of lifetime suicide attempts for currently active Canadian military men and women was 2.2% and 5.6%, respectively. Sexual and other interpersonal traumas (for example, rape, sexual assault, spousal abuse, child abuse) were significantly associated with suicide attempts in both men (adjusted odds ratios [AORs] ranging from 2.31 to 4.43) and women (AORs ranging from 1.73 to 3.71), even after adjusting for sociodemographics and mental disorders. Additionally, the number of traumatic events experienced was positively associated with increased risk of suicide attempts, indicating a dose-response effect of exposure to trauma., Conclusions: The current study is the first to demonstrate that sexual and other interpersonal traumatic events are associated with suicide attempts in a representative sample of active Canadian military men and women.

Purpose: To determine the association between cancer diagnosis, mental disorders and suicidal behavior among community dwelling adults., Methods: Data were drawn from the nationally representative Canadian Community Health Survey Cycle 1.2 (N=36 984, response rate 77%, age 15+). Respondents were grouped into three age groups (15-54, 55-74, and 75+ years), and multiple regression analyses were conducted to examine the relationship between cancer and mental disorders: unadjusted and adjusted for sociodemographics, social supports and other mental disorders., Results: Among respondents aged 15-54, cancer was associated with increased odds of major depression (odds ratio [OR]=3.18; 95% confidence interval [CI]: 1.69-5.96), panic attacks (OR=2.15; 95% CI: 1.22-3.77) and any mental disorder. Among respondents aged 55-75, cancer was associated with increased odds of agoraphobia (OR=5.94; 95% CI: 1.68-21.03) and decreased odds of social phobia (OR=0.22; 95% CI: 0.06-0.80). Cancer was not associated with any mental disorder in the 75+ age group. Results persisted after adjustments for the covariates. Suicidal ideation was associated with cancer in the 55-74 age group (OR=5.07; 95% CI: 1.25-20.47) in unadjusted models; however, this relationship became non-significant when adjusting for the other covariates., Conclusion: Clinicians should consider screening for depression and panic disorder in young, community dwelling patients with cancer., ((c) 2007 John Wiley & Sons, Ltd.)

Objective: There are no previous studies describing the correlates of suicide attempts in individuals with major depressive disorder in a nationally representative sample. This study explores the sociodemographic variables, mental disorders, and specific depressive symptoms associated with suicide attempts in depression., Method: Data were drawn from Wave 1 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a large (N = 43,093) nationally representative survey of mental illness in the United States conducted between 2001 and 2002. Persons with lifetime major depressive disorder (N = 5128; diagnosed according to DSM-IV) were categorized according to the presence (N = 865) or absence (N = 4263) of a lifetime history of suicide attempts. Multivariate logistic regression was used to compare the 2 groups across a broad range of socio-demographic and mental disorder correlates, as well as to compare specific depressive symptoms associated with a history of suicide attempts. Positive predictive values (PPVs) were calculated to evaluate the effectiveness of each correlate in predicting suicide attempts. Analyses were conducted separately for men and women., Results: Sociodemographic factors significantly associated with a history of suicide attempts included Hispanic or Latino ethnicity (p < .05), younger age (p < .01), and low annual income (p < .01). A history of suicide attempt was significantly associated with any anxiety, personality, or substance use disorder among both men and women (all p < .01). Personality disorder comorbidity was most predictive of suicide attempt. In men, suicide attempts had a strong association with dependent personality disorder (adjusted odds ratio [AOR] = 3.81; 95% CI = 1.14 to 12.73), whereas in women, suicide attempts had a strong association with antisocial personality disorder (AOR = 2.71; 95% CI = 1.72 to 4.25). Dependent personality disorder predicted suicide attempt in almost three quarters of depressed men (PPV = 74.3%; 95% CI = 54.2 to 87.6). The depressive symptom most strongly associated with a history of suicide attempts in both men and women was feelings of worthlessness (AOR = 5.48, 95% CI = 3.36 to 8.94 for men; AOR = 4.93, 95% CI = 3.56 to 6.84 for women)., Conclusions: This study contributes to the existing literature on risk factors for suicide attempts in depressed individuals. Identifying specific depressive symptoms and comorbid mental illnesses may improve the clinical assessment of suicide risk in people with major depressive disorder.

Objectives: Investigations of the association between chronic pain conditions and suicidal ideation (SI) and suicide attempts (SA) have rarely taken the effect of mental disorders into account and have been limited by nonrepresentative samples. The present study used a large population-based sample to investigate the association between chronic pain conditions and SI and SA., Methods: Data were from the Canadian Community Health Survey Cycle 1.2 public use file conducted by Statistics Canada from 2001 to 2002 (N=36,984; response rate 77%). Respondents were asked if they had been diagnosed with the following painful conditions: migraine, back problems, arthritis, and fibromyalgia. Respondents were assessed for past 12-month SI and SA. The Composite International Diagnostic Interview was used to assess Diagnostic and Statistical Manual of Mental Disorders-IV., Results: After adjusting for sociodemographics, Axis I mental disorders and comorbidity (3 or more mental disorders), the presence of 1 or more chronic pain conditions was associated with both SI and SA. Among respondents with a mental disorder, comorbidity with 1 or more chronic pain conditions was also associated with SI and SA. In models adjusting for other painful conditions, migraine had the strongest link with SI and SA., Discussion: This is the first study to demonstrate the association between several chronic pain conditions and SI and SA while adjusting for mental disorders in a nationally representative sample. Moreover, this study demonstrates that among individuals with a mental disorder, having a chronic pain condition significantly increased the association with SI and SA.