From Our 2013 Archives
U.S. Troops' Suicide Risk Tied to Mental Illness, Not Combat: StudyBy Amy Norton
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TUESDAY, Aug. 6 (HealthDay News) -- The suicide rate in the U.S. military has risen in recent years, but a large new study finds no proof that the problem directly stems from combat in Iraq and Afghanistan.
Instead, researchers say, the risk factors for suicide in the military are the same as those in the civilian world: depression, drinking problems and being a man. They found no clear link between suicide and the number of deployments to Afghanistan or Iraq, or to combat exposure.
The findings, reported Aug. 7 in the Journal of the American Medical Association, come from a long-range study of more than 150,000 active and retired U.S. military personnel.
Eighty-three of those individuals died by suicide between 2001 and 2008. More than half -- 58 percent -- had not been deployed to Iraq or Afghanistan.
"Deployment was not related to the risk of suicide," said Dr. Nancy Crum-Cianflone of the Naval Health Research Center in San Diego. That does not prove that deployment has nothing to do with suicide risk -- and for certain individuals it may," she added.
"But these findings probably mean that deployment doesn't play a large role," said Crum-Cianflone, the lead researcher on the Millennium Cohort Study, a long-term project following current and retired personnel from all branches of the U.S. military.
The current report is a response to the rising rate of suicide among U.S. troops. Such suicides remain rare, but starting in 2005, they began to rise sharply -- from 10 to 11 per 100,000 active-duty personnel to about 16 per 100,000 in 2008. Since 2009, the annual rate has steadied at about 18 per 100,000 -- which is on par with the rate among all Americans aged 35 to 64, according to a recent government study.
The findings do not mean that the protracted wars in Iraq and Afghanistan have had nothing to do with the increase in military suicides, said experts, including Rachel Yehuda, a professor of psychiatry and neuroscience at Mount Sinai Icahn School of Medicine in New York City.
If the new findings are correct, then rising rates of depression and other mental health diagnoses may help explain the spike in military suicides. Past research has found that, like suicides, those diagnoses have also risen since 2005.
No one knows why. But some have suggested that the years of war and increased demands on all troops, at home and abroad, may be taking a mental health toll, Crum-Cianflone noted.
"But that's just speculation," she said, adding that more research is needed to understand why mental health issues are on the rise.
The current findings are based on nearly 151,600 active-duty and retired personnel, including Reservists and National Guard, who were followed from 2001 to 2008. More than 78,000 of them were deployed in support of the wars in Iraq and Afghanistan. The rest were considered "not deployed."
Overall, troops who'd either screened positive for depression at the start of the study, or reported ever being diagnosed with the disorder, had an increased risk of suicide. Their suicide rate was 27 per 100,000 each year versus 10 per 100,000 among personnel without depression.
There was a similar risk among soldiers with "alcohol-related problems" -- such as a habit of drunk driving. And the relatively small number of soldiers with manic-depression (also known as bipolar disorder) had a particularly high suicide rate, at over 87 per 100,000.
Crum-Cianflone said "for personnel and their families, the results are reassuring in that deployment, itself, does not seem to increase the risk of suicide."
However, the study defined "deployed" as being involved in the Iraq or Afghanistan conflicts in some way -- which is a narrow definition, noted Brett Morash, director of veterans services for the New York-based Services for the UnderServed.
"The military has been at war for 13 years now," said Morash, a recently retired Navy veteran. "But we still have all the worldwide commitments we had before. We're being asked to do more and more, with the same number of people."
That "increasingly high operational tempo" may be adding stress to the lives of service members, regardless of whether they land in Iraq or Afghanistan, Morash said.
Yehuda said the findings highlight the need to screen service members, deployed or not, for depression and drinking problems. She also said that vets should not be afraid to seek help.
"It's not unusual for people to think, 'I can get better on my own,'" Yehuda noted.
Morash agreed that it's important for veterans to reach out for help when they need it. "There are resources out there," he said. For example, the Department of Veterans Affairs and community groups such as Services for the UnderServed have programs that connect vets with other vets who serve as "peer mentors."
"You can talk to another veteran who understands what you're going through," Morash said. "I think that ability to reach out and connect with other vets is key."
SOURCES: Nancy Crum-Cianflone, M.D., lead investigator, Millennium Cohort Study, Naval Health Research Center, San Diego; Rachel Yehuda, Ph.D., director, Traumatic Stress Studies, Icahn School of Medicine, Mount Sinai, New York City; Brett Morash, director, veterans services, Services for the UnderServed, New York City; Aug. 7, 2013, Journal of the American Medical Association