Suicide attempt more common in military personnel with combat exposure

Combat exposure appeared linked to increased risk for suicide attempt among military personnel, according to results of an observational cohort study published in Journal of Clinical Psychiatry.

However, mental disorders, such as PTSD and/or depression, fully mediated this link.

“Our study expands upon prior research by examining the association between specific combat experiences and post-deployment [suicide attempt],” Mia S. Vedtofte, PhD, of the Danish Veteran Centre in Denmark, and colleagues wrote. “Most studies have used self-reported information on suicide attempt, which may be subject to recall and information bias. Using register data may limit such biases, and the use of the unique Danish registers therefore gives us the rare opportunity to conduct a complete sampling of suicide attempts.”

To the researchers’ knowledge, no prior large-scale, national cohort-based epidemiologic study compared specific combat experiences and suicide attempt after deployment. The researchers aimed to address this research gap by analyzing data of 12,218 Danish army military personnel who returned from deployment in international missions between 1998 and 2016 and who completed a questionnaire after deployment. Participants self-reported data on perceived exposure to danger.

The researchers obtained data on suicide attempt via national registers. They used adjusted Cox regression analyses to investigate whether military personnel who reported high levels of combat exposure had increased risk for suicide attempt after deployment compared with those with lower levels of combat exposure.

Results showed 83 suicide attempts after homecoming. Vedtofte and colleagues noted an association between perceived higher exposure to combat and suicide attempt risk (HR = 1.08; 95% CI, 1.01-1.16). PTSD and/or depression symptoms after deployment fully mediated the association between combat exposure and suicide attempt. The researchers observed no association between witnessing consequences of war and the risk for suicide attempt after deployment.