mardi 26 juin 2012

USA : facteurs de risques pensée suicidaire et anciens combattants

Les variations dans l'expérience de combat peut se traduire plus tard dans la pensée suicidaire chez les anciens combattants, selon Shira Maguen, Ph.D., du San Francisco VA Medical Center, et ses collègues. Dans leur rapport en ligne sur les anciens combattants de la guerre du Vietnam dans la revue "Depression and Anxiety" , les chercheurs ont constaté que les anciens combattants ayant vécu des expériences d'homicides dans la guerre étaient plus susceptibles de déclarer des idéations suicidaires. Ceux qui ont des expériences d'homicides qui ont également été diagnostiqués avec le syndrome de stress post-traumatique, la dépression ou les troubles de toxicomanie une avait probabilité encore plus élevée de vivre l'idéation suicidaire.
Comprendre les facteurs qui sous-tendent les tendances suicidaires pourraient aider à sauver des vies. Pour les deux dernières années, les forces armées américaines ont perdu plus de troupes par suicide que par combats. «Les expériences de meurtre ne sont pas systématiquement examinés lors de l'évaluation du risque de suicide», a écrit Maguen et ses collègues. "Nos résultats ont des implications importantes pour la réalisation d'évaluations de risque de suicide chez les vétérans de la guerre."
* étude en ligne en anglais " Killing in Combat May Be Independently Associatedwith Suicidal Ideation" - Shira Maguen, Ph.D. Thomas J. Metzler, M.A., Jeane Bosch, M.P.H. Charles R. Marmar, MD Sara J. Knight, Ph.D. Thomas C. Neylan, MD1, 2012


SOURCE : alert.psychiatricnews.org du 20 juin 2012 "More Killing Experience in War Means More Suicidal Thoughts"

Variations in combat experience may be reflected later in suicidal thinking among veterans, according to Shira Maguen, Ph.D., of the San Francisco VA Medical Center, and colleagues. In their online report on Vietnam War veterans in the journal Depression and Anxiety, the researchers found that veterans with more killing experiences in the war were twice as likely to report suicidal ideation than were veterans with little or no such experience. Those with greater killing experiences who were also diagnosed with posttraumatic stress disorder, depression, or substance use disorders had even higher likelihood of experiencing suicidal ideation.

Understanding the factors that underlie suicidality might help save lives. For the last two years, the U.S. Armed Forces have lost more troops to suicide than to combat. “Killing experiences are not routinely examined when assessing suicide risk,” wrote Maguen and colleagues. “Our findings have important implications for conducting suicide risk assessments in veterans of war.”

To read much more about suicidality among war veterans, see Psychiatric News here. To learn the latest clinical and research findings on treating posttraumatic stress disorder, see Clinical Manual for Management of PTSD from American Psychiatric Publishing.


info +++

Killing in Combat May Be Independently Associated with Suicidal Ideation  Shira Maguen, Ph.D.1, 2  Thomas J. Metzler, M.A.(1, 2)  Jeane Bosch, M.P.H.(1) Charles R. Marmar, MD(3) Sara J. Knight, Ph.D.(1, 2) Thomas C. Neylan, MD(1, 2)
1San Francisco VA Medical Center, San Francisco, CA
2University of California, San Francisco, San Francisco, CA
3New York University Langone Medical Center, New York, NY
Correspondence should be addressed to Shira Maguen, Ph.D., San Francisco VA Medical Center, PTSD Program (116-P), 4150 Clement St. Phone: (415) 221-4810 x 2511 Fax: (415) 379-5562, Email: Shira.Maguen@va.gov.

Keywords: Suicide; Killing; Depression; Stress Disorders, Post-Traumatic; War; Veterans

Abstract
Background: The United States military has lost more troops to suicide than to combat for the second year in a row and better understanding combat-related risk factors for suicide is critical. We examined the association of killing and suicide among war veterans after accounting for PTSD, depression, and substance use disorders.

Methods: We utilized a cross-sectional, retrospective, nationally representative sample of Vietnam veterans from the National Vietnam Veterans Readjustment Study (NVVRS). In order to perform a more in depth analysis, we utilized a sub-sample of these data, the NVVRS Clinical Interview Sample (CIS), which is representative of 1.3 million veterans who were eligible for the clinical interview by virtue of living in proximity to an interview site, located within 28 standard metropolitan regions throughout the United States.

Results: Veterans who had higher killing experiences had twice the odds of suicidal ideation, compared to those with lower or no killing experiences (OR = 1.99, 95% CI = 1.07-3.67), even after adjusting for demographic variables, PTSD, depression, substance use disorders, and adjusted combat exposure. PTSD (OR = 3.42, 95% CI = 1.09-10.73) depression (OR = 11.49, 95% CI = 2.12-62.38), and substance use disorders (OR = 3.98, 95% CI = 1.01-15.60) were each associated with higher odds of suicidal ideation. Endorsement of suicide attempts was most strongly associated with PTSD (OR = 5.52, 95% CI = 1.21-25.29).

Conclusions: Killing experiences are not routinely examined when assessing suicide risk. Our findings have important implications for conducting suicide risk assessments in veterans of war.
étude en ligne en anglais " Killing in Combat May Be Independently Associatedwith Suicidal Ideation" -