WEDNESDAY, March 7 (HealthDay News) -- Suicides among U.S. soldiers rose 80 percent from 2004 to 2008, an Army study found.
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As many as 40 percent of these suicides may have been linked to combat experience in Iraq, yet nearly a third of the soldiers who committed suicide saw no combat at all, said the researchers, from the U.S. Army Public Health Command.
"Our study confirmed earlier studies by other military researchers that found increased risk of suicide among those who experience mental-health diagnoses associated with the stresses of war," said lead researcher Michelle Canham-Chervak, a senior epidemiologist with the command.
"This study suggests that an army engaged in prolonged combat operations is a population under stress, and that mental-health conditions and suicide can be expected to increase under these circumstances," Canham-Chervak said. "By establishing that soldiers who are diagnosed with a mental-health disorder or substance abuse are at greater risk of suicide, we then have a place to target our prevention strategies."
The report was published in the March 7 online edition of the journal Injury Prevention.
The findings are based on analysis of data from the U.S. Army Behavioral Health Integrated Data Environment, a registry containing information -- including consultations, diagnoses and treatment -- on suicides from many military sources.
This analysis found that the rates of suicide among Army personnel from 1977 to 2003 were mostly in keeping with trends in the general population, and were actually slightly lower than expected in that 27-year period, the researchers said.
In 2004, however, suicides started to increase. By 2008 they had risen by more than 80 percent, to a rate higher than in the civilian population.
In 2007 and 2008, 255 soldiers on active duty took their own lives, which is equivalent to a suicide rate of 20 per 100,000 people, compared with a rate of 12 per 100,000 among the general population, the researchers found.
Historical trends for military suicides, compared with 2008 rates, suggested that 39 percent of the suicides might be associated with service in Iraq, where the United States began military action in 2003, or Afghanistan, the researchers said.
Almost half (45 percent) of those who took their lives were between 18 and 24 years old. More than half (54 percent) were among low-ranking soldiers. And 69 percent had been in active combat, researchers said. Male soldiers were at higher risk.
The soldiers who committed suicide were more likely to have been diagnosed with a mental illness in the year before their suicide, the researchers found.
Suicide rates among those hospitalized for mental-health problems were more than 15 times higher than among those who weren't hospitalized. For soldiers who had outpatient consultations for mental problems, the suicide rate was almost four times higher.
The increase in the suicide rate appears related to increased rates of depression, anxiety, post-traumatic stress disorder, substance abuse, personality and adjustment disorders, and serious mental illness, the researchers said. Those with severe depression were more than 11 times more likely to take their lives, and those with anxiety disorders were 10 times more likely to do so, the researchers found.
"A troubling finding was that over 25 percent of the soldiers who committed suicide carried a primary diagnosis of an adjustment disorder," said Simon Rego, supervising psychologist at Montefiore Medical Center in New York City. "Adjustment disorder" is a catchall term for emotional problems resulting from being in a stressful environment, such as combat.
"[Adjustment disorder] is generally used as a short-term diagnosis and/or when a more precise diagnosis has not been identified," Rego said. "[It] is especially prevalent among military trainees."
Researchers also found that 31 percent of suicides were committed by soldiers who had never deployed, which implies that mental problems and stress other than combat exposure may contribute to suicide risk in this population, Rego said.
"While suicide remains a relatively rare event, the results of this study suggest it is increasing at an unprecedented rate and, unlike any other time in history, U.S. military suicide rates now appear to have surpassed those among comparable civilian populations," he said. "It is therefore critical that we address this emerging public-health problem by focusing our efforts on studies like this one, which allow us to identify any and all risk factors for suicide, in order to improve our prevention efforts."
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SOURCES: Michelle Chervak, Ph.D., M.P.H., senior epidemiologist, U.S. Army Public Health Command; Simon Rego, Psy.D., supervising psychologist, Montefiore Medical Center, New York City; March 8, 2012, Injury Prevention