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Relative Importance of Posttraumatic Stress Disorder and Depression in Predicting Risk of Suicide among a Cohort of Vietnam Veterans
Author(s) -
Bullman Tim,
Schneiderman Aaron,
Gradus Jaimie L.
Publication year - 2019
Publication title -
suicide and life‐threatening behavior
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.544
H-Index - 90
eISSN - 1943-278X
pISSN - 0363-0234
DOI - 10.1111/sltb.12482
Subject(s) - hazard ratio , depression (economics) , agent orange , medicine , veterans affairs , psychiatry , cohort , proportional hazards model , confidence interval , cohort study , poison control , relative risk , suicide prevention , medical emergency , history , archaeology , economics , macroeconomics
Objective Research has demonstrated that posttraumatic stress disorder (PTSD) among Vietnam veterans is associated with increased risk of suicide. It is also widely reported that suicide is related to depression. This study examined the effect of PTSD and depression on risk of suicide among a cohort of Vietnam veterans. Method All study subjects were selected from the Department of Veterans Affairs Agent Orange Registry. Suicide risk associated with PTSD was first assessed by comparing the number of suicides among a cohort of 2,874 veterans with PTSD to that of 8,537 veterans not diagnosed with PTSD. Risk of suicide was approximated by hazard ratios (HRs), generated by Cox proportional hazard models, including a model that utilized competing risk analyses. Results The risk of suicide associated with PTSD and depression when examined separately was similar, HR = 7.1 (95% confidence interval (CI): 4.9, 10.3) and HR = 7.2 (95% CI: 4.8–10.8), respectively. Competing risk analysis indicated that veterans with both PTSD and depression compared to veterans with neither diagnosis had the highest risk of suicide, HR = 15.22. Conclusions This study suggests that depression as well as PTSD should be monitored as a way of reducing suicides among Vietnam veterans.