Abstract:
Importance:The US Army suicide attempt rate increased sharply during the wars in Afghanistan and Iraq. Although soldiers with a prior mental health diagnosis (MH-Dx) are known to be at risk, little is known about risk among those with no history of diagnosis. Objective:To examine risk factors for suicide attempt among soldiers without a previous MH-Dx. Design, Setting, and Participants:In this retrospective longitudinal cohort study using administrative data from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS), person-month records were identified for all active-duty Regular Army enlisted soldiers who had a medically documented suicide attempt from January 1, 2004, through December 31, 2009 (n = 9650), and an equal-probability sample of control person-months (n = 153 528). Data analysis in our study was from September 16, 2017, to June 6, 2018. In a stratified sample, it was examined whether risk factors for suicide attempt varied by history of MH-Dx. Main Outcomes and Measures:Suicide attempts were identified using Department of Defense Suicide Event Report records and International Classification of Diseases, Ninth Revision, Clinical Modification E95 × diagnostic codes. Mental health diagnoses and related codes, as well as sociodemographic, service-related, physical health care, injury, subjection to crime, crime perpetration, and family violence variables, were constructed from Army personnel, medical, legal, and family services records. Results:Among 9650 enlisted soldiers with a documented suicide attempt (74.8% male), 3507 (36.3%) did not have a previous MH-Dx. Among soldiers with no previous diagnosis, the highest adjusted odds of suicide attempt were for the following: female sex (odds ratio [OR], 2.6; 95% CI, 2.4-2.8), less than high school education (OR, 1.9; 95% CI, 1.8-2.0), first year of service (OR, 6.0; 95% CI, 4.7-7.7), previously deployed (OR, 2.4; 95% CI, 2.1-2.8), promotion delayed 2 months or less (OR, 2.1; 95% CI, 1.7-2.6), past-year demotion (OR, 1.6; 95% CI, 1.3-1.8), 8 or more outpatient physical health care visits in the past 2 months (OR, 3.3; 95% CI, 2.9-3.8), past-month injury-related outpatient (OR, 3.0; 95% CI, 2.8-3.3) and inpatient (OR, 3.8; 95% CI, 2.3-6.3) health care visits, previous combat injury (OR, 1.6; 95% CI, 1.0-2.4), subjection to minor violent crime (OR, 1.6; 95% CI, 1.1-2.4), major violent crime perpetration (OR, 2.0; 95% CI, 1.3-3.0), and family violence (OR, 2.9; 95% CI, 1.9-4.4). Most of these variables were also associated with suicide attempts among soldiers with a previous MH-Dx, although the strength of associations differed. Conclusions and Relevance:Suicide attempt risk among soldiers with unrecognized mental health problems is a significant and important challenge. Administrative records from personnel, medical, legal, and family services systems can assist in identifying soldiers at risk.
journal_name
JAMA Psychiatryjournal_title
JAMA psychiatryauthors
Ursano RJ,Kessler RC,Naifeh JA,Herberman Mash HB,Nock MK,Aliaga PA,Fullerton CS,Wynn GH,Ng THH,Dinh HM,Sampson NA,Kao TC,Heeringa SG,Stein MBdoi
10.1001/jamapsychiatry.2018.2069subject
Has Abstractpub_date
2018-10-01 00:00:00pages
1022-1032issue
10eissn
2168-622Xissn
2168-6238pii
2697761journal_volume
75pub_type
杂志文章相关文献
JAMA Psychiatry文献大全abstract:IMPORTANCE:The inverse social gradient in mental disorders is a well-established research finding with important implications for causal models and policy. This research has used traditional objective social status (OSS) measures, such as educational level, income, and occupation. Recently, subjective social status (SS...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2014.1337
更新日期:2014-12-01 00:00:00
abstract:Importance:Major depressive disorder (MDD) might involve dopamine (DA) reductions. The DA transporter (DAT) regulates DA clearance and neurotransmission and is sensitive to DA levels, with preclinical studies (including those involving inescapable stressors) showing that DAT density decreases when DA signaling is reduc...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2019.0801
更新日期:2019-08-01 00:00:00
abstract:IMPORTANCE:Mood disorders and alcohol dependence frequently co-occur. Etiologic theories concerning the comorbidity often focus on drinking to self-medicate or cope with affective symptoms. However, there have been few, if any, prospective studies in population-based samples of alcohol self-medication of mood symptoms ...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2013.1098
更新日期:2013-07-01 00:00:00
abstract:IMPORTANCE:Cocaine dependence is a significant public health problem, yet no validated pharmacological treatment exists. The potent γ-aminobutyric acid (GABA)ergic medication vigabatrin has previously been shown to be effective in a double-blind single-site study conducted in Mexico. OBJECTIVE:To evaluate the safety a...
journal_title:JAMA psychiatry
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1001/jamapsychiatry.2013.872
更新日期:2013-06-01 00:00:00
abstract:IMPORTANCE:Neurobiological models of obsessive-compulsive disorder (OCD) predict hyperactivity in brain circuits involving the orbitofrontal cortex and the basal ganglia, but it is unclear whether these areas are also characterized by altered brain network properties. OBJECTIVES:To determine regions of abnormal degree...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2013.173
更新日期:2013-06-01 00:00:00
abstract:Importance:Fatal self-injury in the United States associated with deliberate behaviors is seriously underestimated owing to misclassification of poisoning suicides and mischaracterization of most drug poisoning deaths as "accidents" on death certificates. Objective:To compare national trends and patterns of self-injur...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2016.1870
更新日期:2016-10-01 00:00:00
abstract:Importance:More than 30 million people live with a stroke diagnosis worldwide. Depression after stroke is frequent, and greater knowledge of associated risk factors and outcomes is needed to understand the etiology and implications of this disabling complication. Objectives:To examine whether the incidence of and risk...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2016.1932
更新日期:2016-10-01 00:00:00
abstract:IMPORTANCE:The neural systems that confer risk or vulnerability for developing familial depression, and those that protect against or confer resilience to becoming ill, can be disentangled from the effects of prior illness by comparing brain imaging measures in previously ill and never ill persons who have either a hig...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2013.4048
更新日期:2014-02-01 00:00:00
abstract:IMPORTANCE:At least 11 rare copy number variants (CNVs) have been shown to be major risk factors for schizophrenia (SZ). These CNVs also increase the risk for other neurodevelopmental disorders, such as intellectual disability. It is possible that additional intellectual disability-associated CNVs increase the risk for...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2016.1831
更新日期:2016-09-01 00:00:00
abstract:Importance:Autism spectrum disorder (ASD) is 2 to 5 times more common in male individuals than in female individuals. While the male preponderant prevalence of ASD might partially be explained by sex differences in clinical symptoms, etiological models suggest that the biological male phenotype carries a higher intrins...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2016.3990
更新日期:2017-04-01 00:00:00
abstract:IMPORTANCE:The structural abnormalities in the brain that accurately differentiate unipolar depression (UD) and bipolar depression (BD) remain unidentified. OBJECTIVES:First, to investigate and compare morphometric changes in UD and BD, and to replicate the findings at 2 independent neuroimaging sites; second, to diff...
journal_title:JAMA psychiatry
pub_type: 杂志文章,多中心研究
doi:10.1001/jamapsychiatry.2014.1100
更新日期:2014-11-01 00:00:00
abstract:Importance:This article briefly reports the experience of mental health services and the lessons learned during the coronavirus disease 2019 (COVID-19) crisis. In particular, this report offers opportunities to build on experience gained in managing the COVID-19 emergency in the Departments of Mental Health and Addicti...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2020.1276
更新日期:2020-09-01 00:00:00
abstract:IMPORTANCE:Community functioning is a core component of the functional deficits in schizophrenia, yet little systematic research on the origins of these functional deficits has been performed. OBJECTIVES:To examine 3 key domains of community functioning--social activity, independent behavior, and functioning in school...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2015.2253
更新日期:2016-01-01 00:00:00
abstract:Importance:Bipolar disorder (BD) overlaps schizophrenia in its clinical presentation and genetic liability. Alternative approaches to patient stratification beyond current diagnostic categories are needed to understand the underlying disease processes and mechanisms. Objective:To investigate the association between co...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2017.3485
更新日期:2018-01-01 00:00:00
abstract:Importance:Although several strategies of repetitive transcranial magnetic stimulation (rTMS) have been investigated as treatment of major depressive disorder (MDD), their comparative efficacy and acceptability is unknown. Objective:To establish the relative efficacy and acceptability of the different modalities of rT...
journal_title:JAMA psychiatry
pub_type: 杂志文章,meta分析,评审
doi:10.1001/jamapsychiatry.2016.3644
更新日期:2017-02-01 00:00:00
abstract:IMPORTANCE:Cigarette smoking leads to upregulation of nicotinic acetylcholine receptors (nAChRs) in the human brain, including the common α4β2* nAChR subtype. While subjective aspects of tobacco dependence have been extensively examined as predictors of quitting smoking with treatment, no studies to our knowledge have ...
journal_title:JAMA psychiatry
pub_type: 杂志文章,随机对照试验
doi:10.1001/jamapsychiatry.2014.138
更新日期:2014-07-01 00:00:00
abstract:Importance:Obesity is associated with an increased prevalence of psychiatric disorders. The association of bariatric surgery with mental health outcomes is poorly understood. Objective:To investigate the association of bariatric surgery with the incidence of outpatient, emergency department (ED), and inpatient mental ...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2019.2741
更新日期:2020-01-01 00:00:00
abstract:IMPORTANCE:Cocaine addiction is associated with altered resting-state functional connectivity among regions of the mesocorticolimbic dopamine pathways. Methylphenidate hydrochloride, an indirect dopamine agonist, normalizes task-related regional brain activity and associated behavior in cocaine users; however, the neur...
journal_title:JAMA psychiatry
pub_type: 杂志文章,随机对照试验
doi:10.1001/jamapsychiatry.2013.1129
更新日期:2013-08-01 00:00:00
abstract:IMPORTANCE:Adverse childhood experiences (ACEs) are associated with several adulthood health problems, such as self-directed violence. For some individuals, enlistment in the military may be an instrumental act to escape adverse household environments; however, to our knowledge prevalence of ACEs among persons with a h...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2014.724
更新日期:2014-09-01 00:00:00
abstract:Importance:Little is known about changes in marijuana use and cannabis use disorder (CUD) after recreational marijuana legalization (RML). Objectives:To examine the associations between RML enactment and changes in marijuana use, frequent use, and CUD in the United States from 2008 to 2016. Design, Setting, and Parti...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2019.3254
更新日期:2020-02-01 00:00:00
abstract::IMPORTANCE—Suicide can be viewed as an escape from unendurable punishment at the cost of any future rewards. Could faulty estimation of these outcomes predispose to suicidal behavior? In behavioral studies, many of those who have attempted suicide misestimate expected rewards on gambling and probabilistic learning tas...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2013.75
更新日期:2013-10-01 00:00:00
abstract::In 1893 and 1896, in his fourth and fifth textbook editions, Emil Kraepelin brought together 3 syndromes to form the first and second of his 2 prequels to dementia praecox (DP), a definitive version of which he would propose in his 1899 sixth textbook edition. These syndromes, which would become hebephrenic DP, catato...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2020.1266
更新日期:2020-06-10 00:00:00
abstract:IMPORTANCE:The single-nucleotide polymorphism rs1344706 in the zinc finger protein 804A gene (ZNF804A) shows genome-wide association with schizophrenia and bipolar disorder. Little is known regarding the expression of ZNF804A and the functionality of rs1344706. OBJECTIVES:To characterize ZNF804A expression in human br...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2014.1079
更新日期:2014-10-01 00:00:00
abstract:IMPORTANCE:Sedentary behaviors and physical inactivity are not only increasing worldwide but also are critical risk factors for adverse health outcomes. Yet, few studies have examined the effects of sedentary behavior on cognition or the long-term role of either behavior in early to middle adulthood. OBJECTIVE:To inve...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2015.2468
更新日期:2016-01-01 00:00:00
abstract:Importance:Generalized anxiety disorder (GAD) is poorly understood compared with other anxiety disorders, and debates persist about the seriousness of this disorder. Few data exist on GAD outside a small number of affluent, industrialized nations. No population-based data exist on GAD as it is currently defined in DSM-...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2017.0056
更新日期:2017-05-01 00:00:00
abstract:IMPORTANCE:Developmental brain disorders are a group of clinically and genetically heterogeneous disorders characterized by high heritability. Specific highly penetrant genetic causes can often be shared by a subset of individuals with different phenotypic features, and recent advances in genome sequencing have allowed...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2015.2692
更新日期:2016-03-01 00:00:00
abstract:IMPORTANCE:Alterations in glutamatergic neurotransmission have been postulated to be a key pathophysiologic mechanism in schizophrenia. OBJECTIVE:To evaluate hippocampal volumetric measures and neurometabolites in unmedicated patients with schizophrenia and the correlations between these markers. Our a priori hypothes...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2013.2437
更新日期:2013-12-01 00:00:00
abstract:IMPORTANCE:Some, but not all, previous magnetic resonance imaging studies have indicated smaller cortical and local gray matter volumes (GMVs) in men with schizotypal personality disorder (SPD) compared with healthy control (HC) subjects. Thus, there is need for a whole-brain comparison to resolve inconsistencies and p...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2013.665
更新日期:2013-04-01 00:00:00
abstract:Importance:Substance abuse preventive interventions frequently target middle school students and demonstrate efficacy to prevent early onset and use of alcohol and illicit drugs. However, evidence of sustained results to prevent later patterns of alcohol misuse and more serious alcohol abuse disorders has been lacking,...
journal_title:JAMA psychiatry
pub_type: 杂志文章,随机对照试验
doi:10.1001/jamapsychiatry.2018.0058
更新日期:2018-05-01 00:00:00
abstract:IMPORTANCE:Compulsory admissions, defined as admissions against the will of the patient (according to local judicial procedures), have a strong effect on psychiatric patients. In several Western countries, the rate of such admissions is tending to rise. Its reduction is urgently needed. OBJECTIVE:To establish which in...
journal_title:JAMA psychiatry
pub_type: 杂志文章,meta分析,评审
doi:10.1001/jamapsychiatry.2016.0501
更新日期:2016-07-01 00:00:00