Predicting suicide in the absence of mental illness

  • JAMA Psychiatry

  • curated by Jim Kling
  • Clinical Essentials
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Takeaway

  • Predictors of suicide attempts among patients with no previous mental health diagnosis emerge from a retrospective survey of US Army administrative data.
  • Sex, education level, deployment history, demotion, health care visits, exposure to violence, and other factors are predictive.

Why this matters

  • Mental health diagnoses are predictive of suicide attempts and deaths, but fewer than half of soldiers who die by suicide have received a mental health diagnosis.
  • The results suggest it may be possible to analyze administrative data among service personnel to identify individuals at high risk for suicide attempt.

Study design

  • Longitudinal cohort study (regular army enlisted soldiers with history of suicide attempt, n=9650; equal probability sample, n=153,528 control person-months).
  • Funding: None disclosed.

Key results

  • 36.3% of soldiers who had attempted suicide had no history of mental health diagnosis.
  • The odds of suicide attempt were highest among soldiers who (ORs [95% CIs]):
    • were in their first year of service: 6.0 (4.7-7.7);
    • had inpatient health care visits: 3.8 (2.3-6.3);
    • had experienced family violence: 2.9 (1.9-4.4);
    • were female: 2.6 (2.4-2.8);
    • were previously deployed: 2.4 (2.1-2.8);
    • had less than a high school education: 1.9 (1.8-2.0); and
    • had a past-year demotion: 1.6 (1.3-1.8).

Limitations

  • Findings may not be generalizable. 

Coauthored with Chitra Ravi, MPharm

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