By SHIRLEY S. WANG
October 31, 2007; Page D8
The results from a study of 800,000 depressed military veterans challenge assumptions that those suffering from posttraumatic stress disorder or other service-related disabilities are more prone to kill themselves.
The study also suggests that among depressed veterans, younger men may suffer a higher suicide risk than previously thought.
The findings, published yesterday in the American Journal of Public Health, could help better focus psychiatric care for veterans at a time when their medical treatment has become a public-health and political issue. The suicide rate for veterans is higher across many studies than the general population's rate. Suicide prevention in veterans is a government priority, says Ira Katz, head of mental-health services in the Department of Veteran Affairs Central Office.
"Just assuming that a certain type or group of patients is at higher risk may not be correct," says Kara Zivin, lead author of the study and investigator at the VA's National Serious Mental Illness Treatment Research and Evaluation Center. Instead, carefully assessing all depressed patients for suicidal intent is important, Dr. Zivin says.
Other major risk factors for suicide, such as drug or alcohol use and psychiatric hospitalization within the past year, were found to be consistent with what is known of the general population.
The study examined medical records of veterans who were in the VA health-care system from 1999 to 2004, so it didn't include large portions of those serving in Iraq and Afghanistan.
Last week, Congress passed a bill on veteran suicide prevention designed to provide more mental-health training for VA staff, improve screening and increase referrals for treatment.
It isn't clear why posttraumatic stress disorder appears to be unrelated to increased suicide rates, but researchers say there is some evidence that veterans with the disorder are more likely to come to the attention of medical personnel and have more frequent contact with doctors. Those who fail to seek help, then, may actually be most vulnerable to killing themselves.
More research on depression and suicide among veterans is necessary to understand what to do, says Ronald C. Kessler, a health-policy professor at Harvard Medical School who wasn't involved in the study. "Is there any way for us to forecast that, so we can do some kind of intervention to do something about it?" he says.