1. A National Cohort Study of the Association Between the Polytrauma Clinical Triad and Suicide-Related Behavior Among US Veterans Who Served in Iraq and Afghanistan.
- Author
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Finley, Erin P., Bollinger, Mary, Noël, Polly H., Amuan, Megan E., Copeland, Laurel A., Pugh, Jacqueline A., Dassori, Albana, Palmer, Raymond, Bryan, Craig, and Pugh, Mary Jo V.
- Subjects
COMPLICATIONS of brain injuries ,SUICIDE risk factors ,AMERICAN veterans ,ALGORITHMS ,CHI-squared test ,CONFIDENCE intervals ,STATISTICAL correlation ,LONGITUDINAL method ,MEDICAL records ,MILITARY research ,PAIN ,POST-traumatic stress disorder ,QUESTIONNAIRES ,RESEARCH funding ,STATISTICS ,T-test (Statistics) ,MULTIPLE regression analysis ,RETROSPECTIVE studies ,DATA analysis software ,DESCRIPTIVE statistics ,ODDS ratio - Abstract
Objectives. We examined the association of posttraumatic stress disorder (PTSD), traumatic brain injury, and chronic pain—the polytrauma clinical triad (PCT)—independently and with other conditions, with suicide-related behavior (SRB) risk among Operation Enduring Freedom (OEF; Afghanistan) and Operation Iraqi Freedom (OIF) veterans. Methods. We used Department of Veterans Affairs (VA) administrative data to identify OEF and OIF veterans receiving VA care in fiscal years 2009–2011; we used International Classification of Diseases, Ninth Revision, Clinical Modification codes to characterize 211 652 cohort members. Descriptive statistics were followed by multinomial logistic regression analyses predicting SRB. Results. Co-occurrence of PCT conditions was associated with significant increase in suicide ideation risk (odds ratio [OR] = 1.9; 95% confidence interval [CI] = 1.5, 2.4) or attempt and ideation (OR = 2.6; 95% CI = 1.5, 4.6), but did not exceed increased risk with PTSD alone (ideation: OR = 2.3; 95% CI = 2.0, 2.6; attempt: OR = 2.0; 95% CI = 1.4, 2.9; ideation and attempt: OR = 1.8; 95% CI = 1.2, 2.8). Ideation risk was significantly elevated when PTSD was comorbid with depression (OR = 4.2; 95% CI = 3.6, 4.8) or substance abuse (OR = 4.7; 95% CI = 3.9, 5.6). Conclusions. Although PCT was a moderate SRB predictor, interactions among PCT conditions, particularly PTSD, and depression or substance abuse had larger risk increases. ( [ABSTRACT FROM AUTHOR]
- Published
- 2015
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