Search

Background: Researchers have theorized that increased rates of suicide in the military are associated with combat exposure; however, this hypothesis has received inconsistent support in the literature, potentially because combat exposure may be indirectly related to suicide risk through its influence on posttraumatic stress disorder (PTSD) and depressive symptoms. The current study tested the hypothesis that combat exposure has a significant indirect effect on suicidal behavior among Iraq/Afghanistan-era veterans through its effects on PTSD-depressive symptomatology.Methods: Iraq/Afghanistan-era veterans (N = 3,238) participated in a cross-sectional, multi-site study of post-deployment mental health consisting of clinical interviews and self-report questionnaires. Structural equation modeling (SEM) was used to examine direct and indirect relationships between three latent variables: combat exposure, PTSD-depression, and suicidal behavior (past attempts and current ideation, intent, and preparation).Results: A partial mediation model was the best-fitting model for the data. Combat exposure was significantly associated with PTSD-depression (β = 0.50, p < .001), which was in turn associated with suicidal behavior (β = 0.62, p < .001). As expected, the indirect effect between combat exposure and suicidal behavior was statistically significant, β = 0.31, p < .001.Limitations: Data were cross-sectional, and suicidal behavior was measured via self-report.Conclusions: Results indicated that combat exposure was indirectly related to suicidal behavior via PTSD-depressive symptomatology. Findings lend support for a higher-order combined PTSD-depression latent factor and suggest that Iraq/Afghanistan-era veterans with high levels of PTSD-depressive symptoms are at increased risk for suicidal behavior. [ABSTRACT FROM AUTHOR]

Background: Very little is known regarding the epidemiology of suicides in Iraq, given the lack of a national surveillance system. Therefore, the government initiated this project "The Iraqi National Study of Suicide METHODS: The study covered 13 (out of 18) provinces in Iraq. A data collection form was designed by the researchers. The forms were completed by police stations in the 13 provinces. Data were extracted from the legal investigation (which include police investigation, family reports and postmortem reports) of cases of when there was no clear cause of death and where there was final verdict of suicide made by judge after examining these reports.Results: There were 647 cases of suicide. The crude rate of suicide per 100 000 population was 1.09 (1.21 for males, 0.97 for females) in 2015 and 1.31 (1.54 for males and 1.07 for females) in 2016. The majority of cases (67.9%) were aged 29 years or below. The most common method was hanging (41%) followed by firearms (31.4%) and self-burning (19.2%). 24.1% of cases were reported to have psychiatric disorders, of which the most common diagnosis was depression (53.9%). In the majority of cases (82.1%) there were no previous attempts. Only a small minority were reported to have had psychological trauma (15.5%), financial problems (12.4%) or childhood abuse (2.2%).Limitations: The study covered only 13 provinces in Iraq. We were able to calculate age-standardized rates for year 2016 only. Data are based on official police records and under-reporting and under-recognition of psychiatric disorders are possible.Conclusion: On the basis of data available to this study, the suicide rate in Iraq is lower than the global rate. Suicide is more common in young people, where the gender distribution is almost equal. Social and cultural factors might have played a role in these patterns. The findings underscore the need of a national registry with a comprehensive and multipronged surveillance approach to correctly identify suicide events. This study aims to be the first step in this process. [ABSTRACT FROM AUTHOR]

Objective: Despite concerns regarding elevated psychiatric morbidity and suicide among veterans returning from Operations Enduring Freedom and Iraqi Freedom (OEF/OIF), little is known about the impact of psychiatric conditions on the risk of suicide in these veterans. To inform tailored suicide prevention efforts, it is important to assess interrelationships between OEF/OIF status, psychiatric morbidity, and suicide mortality. This study sought to examine potential associations between OEF/OIF status and suicide mortality among individuals receiving care in the Department of Veterans Affairs health system, the Veterans Health Administration (VHA). Analyses assessed potential interactions between OEF/O1F status and psychiatric conditions as predictors of suicide. Method: Analyses included data for all individuals who received VHA services during fiscal year (FY) 2007 or FY08 and were alive at the start of FY08 (N = 5,772,282). Results: For this cohort, there were 1,920 suicide deaths in FY08, including 96 among OEF/O1F veterans. Controlling for demographic factors, psychiatric conditions, OEF/OIF status, and the interaction between psychiatric conditions and OEF/OIF status, no main effects of OEF/OIF status were observed. However, a significant interaction was found between psychiatric conditions and OEF/OIF status. Specifically, having a diagnosed mental health condition was associated with a greater risk of suicide among OEF/OIF veterans (hazard ratio [HR] = 4.41; 95% confidence interval [CI]: 2.57, 7.55; p < .01) than among non-OEF/OIF veterans (HR = 2.48; 95% CI [2.27, 2.71]; p < .01). Conclusion: These findings highlight the importance of mental health screening and intervention for OEF/OIF veterans. [ABSTRACT FROM AUTHOR]

There have been studies about the impact of a suicide on family members and friends, but none to date on a military unit in a combat zone. This is the first description, to my knowledge, of the effects of the suicide of a U.S. Army soldier deployed to Iraq. A narrative from the treating psychiatrist's perspective describes both the acute and longer-term (four months) effects of the suicide on members of the soldier's unit, other soldiers at the same base, members of the medical team who attempted to resuscitate him, and mental health care providers. This account describes how the suicide affected at least thirteen other soldiers on the base. The effects of the soldier's suicide showed a few similarities to those described in the literature, including stigmatization of the survivors and the stress experienced by the mental health providers. There were additional repercussions that have not been previously described, including the impact on the soldier's peers within his unit and other soldiers on the base, the need for medical evacuation from Iraq of soldiers following the event, and the reported stress on the medical staff due to the attempted resuscitation of someone known to them. Future research is needed to understand the impact of a suicide on the survivors in a deployed military setting and to establish best practices for postvention strategies. [ABSTRACT FROM AUTHOR]

In this article the author discusses the article "When a Soldier Commits Suicide in Iraq: Impact on Unit and Caregivers," by Dr. Russell Carr and the challenges poses by suicide in the U.S. Army. He says that the suicide case provided by Carr highlights the unique psychosocial aspects for suicide provided in the combat environments of soldiers despite the training they undergone. Moreover , the Army and Defense Department conduct early test to provide early treatment for stressed individuals.

In this article the author discusses the article "When a Soldier Commits Suicide in Iraq: Impact on Unit and Caregivers," by Dr. Russell Carr and the lessons it offer to avoid suicide cases. He says that the suicide case provided Carr shows that such acts provide guilt feelings, sense of shock, and distresses the confidence in the combat stress team. He notes that memorials of someone who dies by suicide can be used to honor soldier's memory and stress the needs of seeking help with stress.

In this article the author discusses the article "When a Soldier Commits Suicide in Iraq: Impact on Unit and Caregivers," by Dr. Russell Carr. He says that the article's use of a case provides rich details and understanding on suicide issues and opportunities limited to observation of investigator-derived hypotheses. He adds that Carr shows the potential contribution of work in soldiers' high psychological distress. He adds that the article highlights the need to improve suicide prediction.

In this article the author discusses the lessons learned from doctor Russell Carr's report "When a Soldier Commits Suicide in Iraq: Impact on Unit and Caregivers." She states that a military suicide during the time of deployment will have an impact to all the involved individuals. She relates that the evidence-informed approaches for suicide risk assessment and management and postvention during the time of deployment does not exist but they were needed.

In this article the author discusses doctor Russell Carr's report "When a Soldier Commits Suicide in Iraq: Impact on Unit and Caregivers." He mentions that Carr offers his perspective regarding the acute and intermediate impact of soldier suicide in the combat environment for the psychiatrist and other members of the treatment team. He relates that Carr provides the emotional responses to the incidence as well as its impact to the members of the soldier's unit and other military personnel.