BACKGROUND Suicidal thoughts are common among veterans with posttraumatic stress disorder (PTSD). The aim of this study was to examine the prevalence and correlates of four courses of suicidal (SI) among veterans receiving residential PTSD treatment. METHODS A total of 1,807 veterans receiving residential PTSD treatment at Department of Veterans Affairs medical facilities who completed self-report measures at admission and discharge were included. RESULTS The prevalence of SI courses were No SI (33.6%), Remitted SI (23.0%), SI onset (6.0%), and Chronic SI (37.4%). There were group differences between the four SI courses in PTSD symptoms at baseline, magnitude of PTSD symptom change during treatment, race/ethnicity and baseline depression, substance use, physical functioning, and pain. Chronic SI was associated with highest baseline PTSD, depression, substance use, pain and worse physical functioning. Remitted SI course was associated with greatest pre-posttreatment PTSD improvement, followed by No SI, Chronic SI, and SI Onset. Multinomial logistic regressions revealed that PTSD symptom improvement and baseline PTSD symptoms most consistently related to symptomatic SI courses compared to less symptomatic or No SI courses. Receipt of trauma-focused psychotherapy (none, some, or adequate) and length of stay were not related to SI courses and did not differ between groups. CONCLUSIONS Findings indicate that treating PTSD symptoms could be impactful for reducing suicidal thoughts. Although many veterans had remitted or reduced severity of SI at discharge, a significant proportion of veterans reported SI at discharge (43.4%), potentially highlighting the need for suicide specific treatment interventions within the context of PTSD treatment.

中文翻译：

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创伤后应激障碍住院治疗退伍军人的自杀意念课程。

背景自杀想法在患有创伤后应激障碍（PTSD）的退伍军人中很常见。本研究的目的是调查接受住院 PTSD 治疗的退伍军人中四个自杀过程 (SI) 的患病率和相关性。方法 共有 1,807 名在退伍军人事务部医疗机构接受住院 PTSD 治疗的退伍军人纳入研究，他们在入院和出院时完成了自我报告措施。结果SI病程发生率依次为无SI（33.6%）、缓解SI（23.0%）、SI发作（6.0%）和慢性SI（37.4%）。四个 SI 疗程之间在基线 PTSD 症状、治疗期间 PTSD 症状变化程度、种族/民族和基线抑郁、物质使用、身体机能和疼痛方面存在组间差异。慢性 SI 与最高基线 PTSD、抑郁、药物滥用、疼痛和身体机能较差有关。SI 缓解过程与治疗前 PTSD 最大改善相关，其次是无 SI、慢性 SI 和 SI 发作。多项 Logistic 回归显示，与症状较少或无 SI 过程相比，PTSD 症状改善和基线 PTSD 症状与症状性 SI 过程最一致相关。是否接受以创伤为中心的心理治疗（没有、部分或充分）和住院时间与 SI 疗程无关，并且组间没有差异。结论 研究结果表明，治疗创伤后应激障碍症状可能有助于减少自杀念头。尽管许多退伍军人在出院时 SI 的严重程度得到缓解或减轻，但很大一部分退伍军人在出院时报告了 SI（43.4%），这可能凸显了在 PTSD 治疗背景下对自杀特定治疗干预的需要。