Sex Differences in US Army Suicide Attempts During the Wars in Iraq and Afghanistan.
Adult
Afghan Campaign 2001-
Cohort Studies
Database Management Systems
Female
Humans
Iraq War, 2003-2011
Longitudinal Studies
Male
Military Personnel
/ statistics & numerical data
Retrospective Studies
Sex Factors
Suicide, Attempted
/ statistics & numerical data
United States
United States Department of Defense
Young Adult
Journal
Medical care
ISSN: 1537-1948
Titre abrégé: Med Care
Pays: United States
ID NLM: 0230027
Informations de publication
Date de publication:
01 02 2021
01 02 2021
Historique:
entrez:
13
1
2021
pubmed:
14
1
2021
medline:
7
4
2021
Statut:
ppublish
Résumé
To examine sex differences in risk for administratively documented suicide attempt (SA) among US Army soldiers during the Iraq/Afghanistan wars. Using administrative person-month records of Regular Army enlisted soldiers from 2004 to 2009, we identified 9650 person-months with a first documented SA and an equal-probability control sample (n=153,528 person-months). Person-months were weighted to the population and pooled over time. After examining the association of sex with SA in a logistic regression analysis, predictors were examined separately among women and men. Women (an estimated 13.7% of the population) accounted for 25.2% of SAs and were more likely than men to attempt suicide after adjusting for sociodemographic, service-related, and mental health diagnosis (MHDx) variables (odds ratio=1.6; 95% confidence interval, 1.5-1.7). Women with increased odds of SA in a given person-month were younger, non-Hispanic White, less educated, in their first term of enlistment, never or previously deployed (vs. currently deployed), and previously received a MHDx. The same variables predicted SA among men. Interactions indicated significant but generally small differences between women and men on 6 of the 8 predictors, the most pronounced being time in service, deployment status, and MHDx. Discrete-time survival models examining risk by time in service demonstrated that patterns for women and men were similar, and that women's initially higher risk diminished as time in service increased. Predictors of documented SAs are similar for US Army women and men. Differences associated with time in service, deployment status, and MHDx require additional research. Future research should consider stressors that disproportionately affect women.
Identifiants
pubmed: 33438882
doi: 10.1097/MLR.0000000000001425
pii: 00005650-202102001-00012
pmc: PMC7810153
mid: NIHMS1624021
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
S42-S50Subventions
Organisme : NIMH NIH HHS
ID : U01 MH087981
Pays : United States
Déclaration de conflit d'intérêts
In the past 3 years, R.C.K. received support for his epidemiological studies from Sanofi Aventis; was a consultant for Datastat Inc., Johnson & Johnson Wellness and Prevention, Sage Pharmaceuticals, Shire, Takeda; and served on an advisory board for the Johnson & Johnson Services Inc. Lake Nona Life Project. M.B.S. has in the past 3 years been a consultant for Actelion, Alkermes, Aptinyx, Bionomics, Dart Neuroscience, Healthcare Management Technologies, Janssen, Neurocrine Biosciences, Oxeia Biopharmaceuticals, Pfizer, and Resilience Therapeutics. M.B.S. has stock options in Oxeia Biopharmaceuticals. The remaining authors declare no conflict of interest.
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