Objective:

The authors sought to identify predictors of imminent suicide attempt (within 30 days) among U.S. Army soldiers following their first documented suicidal ideation.

Methods:

Using administrative data from the Army Study to Assess Risk and Resilience in Servicemembers, the authors identified 11,178 active-duty Regular Army enlisted soldiers (2006–2009) with medically documented suicidal ideation and no prior medically documented suicide attempts. The authors examined risk factors for suicide attempt within 30 days of first suicidal ideation using logistic regression analyses, including sociodemographic and service-related characteristics, psychiatric diagnoses, physical health care visits, injuries, and history of family violence or crime perpetration or victimization.

Results:

Among soldiers with first documented suicidal ideation, 830 (7.4%) attempted suicide, 46.3% of whom (N=387) attempted suicide within 30 days (rate, 35.4 per 1,000 soldiers). Following a series of multivariate analyses, the final model identified females (odds ratio=1.3, 95% CI=1.0, 1.8), combat medics (odds ratio=1.6, 95% CI=1.1, 2.2), individuals with an anxiety disorder diagnosis prior to suicidal ideation (odds ratio=1.3, 95% CI=1.0, 1.6), and those who received a sleep disorder diagnosis on the same day as the recorded suicidal ideation (odds ratio=2.3, 95% CI=1.1, 4.6) as being more likely to attempt suicide within 30 days. Black soldiers (odds ratio=0.6, 95% CI=0.4, 0.9) and those who received an anxiety disorder diagnosis on the same day as suicidal ideation (odds ratio=0.7, 95% CI=0.5, 0.9) were less likely.

Conclusions:

Suicide attempt risk is highest in the first 30 days following ideation diagnosis and is more likely among women, combat medics, and soldiers with an anxiety disorder diagnosis before suicidal ideation and a same-day sleep disorder diagnosis. Black soldiers and those with a same-day anxiety disorder diagnosis were at decreased risk. These factors may help identify soldiers at imminent risk of suicide attempt.

中文翻译：

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美国陆军士兵首次有医学记录的自杀意念后 30 天内自杀未遂的预测因素

客观的：

作者试图确定美国陆军士兵在他们第一次有记录的自杀意念后即将发生自杀企图（30 天内）的预测因素。

方法：

使用陆军研究中的管理数据来评估军人的风险和复原力，作者确定了 11,178 名现役正规军入伍士兵（2006-2009 年），他们有医学上记录的自杀意念，并且之前没有医学上记录的自杀企图。作者使用逻辑回归分析检查了第一次自杀意念后 30 天内自杀未遂的危险因素，包括社会人口学和服务相关特征、精神病诊断、身体保健就诊、伤害以及家庭暴力或犯罪实施或受害史。

结果：

在首次记录有自杀念头的士兵中，830 人（7.4%）企图自杀，其中 46.3%（N=387）在 30 天内企图自杀（比率为每 1,000 名士兵 35.4 人）。经过一系列多变量分析，最终模型确定了女性（优势比 = 1.3、95% CI = 1.0、1.8）、战斗医务人员（优势比 = 1.6、95% CI = 1.1、2.2）、患有焦虑症的个体在有自杀意念之前（比值比=1.3, 95% CI=1.0, 1.6），以及在记录的自杀意念同一天接受睡眠障碍诊断的人（比值比=2.3, 95% CI=1.1, 4.6）因为更有可能在 30 天内企图自杀。黑人士兵（比值比=0.6, 95% CI=0.4, 0.9）和在同一天接受焦虑症诊断的自杀意念（比值比=0.7, 95% CI=0.5, 0.9）的可能性较小。

结论：

自杀意念诊断后的前 30 天内，自杀未遂风险最高，女性、战斗医务人员和在自杀意念和当日睡眠障碍诊断之前诊断为焦虑症的士兵中更有可能发生自杀未遂风险。黑人士兵和那些在同一天被诊断出焦虑症的人的风险降低了。这些因素可能有助于识别即将面临自杀未遂风险的士兵。