退伍军人健康管理局(VHA)中经历过军队性创伤的退伍军人自杀未遂的预测因素。

IF 2.7 3区 医学 Q2 PSYCHIATRY Suicide and Life-Threatening Behavior Pub Date : 2024-04-01 Epub Date: 2024-02-29 DOI:10.1111/sltb.13038
Tyler C Hein, Karen Austin, Peter P Grau, Jessica A Keith, Nathan J Claes, Nicholas W Bowersox
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引用次数: 0

摘要

目的:军事性创伤(MST)已被确定为自杀行为的风险因素。为了给退伍军人健康管理局(VHA)内的自杀预防工作提供信息,本研究评估了经历过 MST 的 VHA 患者非致命性自杀未遂(NFSA)的预测因素:对于 2019 财政年度(FY)的退伍军人健康管理局(VHA)患者,如果之前筛查出其 MST 史呈阳性,则对有记录的 NFSA 进行评估。使用多变量逻辑回归评估了NFSAs的人口统计学、临床和VHA护理利用预测因素:在2019财年之前筛查出MST阳性的212215名VHA患者中,有1742人(0.8%)在2019财年有记录在案的NFSA,这些患者有完整的种族、服务连接和乡村信息。在多变量逻辑回归分析中,身体和精神健康的总发病率与 NFSA 风险无关。有记录的 NFSA 的预测因素包括特定的精神健康诊断[调整后的几率(aOR)范围:1.28-1.94]、接受精神药物处方(aOR 范围:1.23-2.69)以及上一年急诊就诊(aOR = 1.32)或精神科住院(aOR = 2.15):结论:在经历过 MST 的退伍军人医疗服务局患者中,特定的精神健康状况可能会增加 NFSA 的风险,即使在对总体精神健康发病率进行调整后也是如此。此外,精神健康问题严重程度的指标,如接受精神药物处方和精神科住院治疗,也会增加与诊断相关风险之外的风险。研究结果强调了在退伍军人事务部内这一弱势群体中开展自杀预防措施的目标,并可能有助于确定哪些病人会从额外的支持中受益。
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Predictors of non-fatal suicide attempts among Veterans Health Administration (VHA) patients who experienced military sexual trauma.

Objective: Military sexual trauma (MST) has been identified as a risk factor for suicidal behavior. To inform suicide prevention efforts within the Veterans Health Administration (VHA), this study evaluates predictors of non-fatal suicide attempts (NFSAs) among VHA patients who experienced MST.

Methods: For VHA patients in fiscal year (FY) 2019 who previously screened positive for a history of MST, documented NFSAs were assessed. Using multivariable logistic regression, demographic, clinical, and VHA care utilization predictors of NFSAs were assessed.

Results: Of the 212,215 VHA patients who screened positive for MST prior to FY 2019 and for whom complete race, service connection, and rurality information was available, 1742 (0.8%) had a documented NFSA in FY 2019. In multivariable logistic regression analyses, total physical and mental health morbidities were not associated with NFSA risk. Predictors of a documented NFSA included specific mental health diagnoses [adjusted odds ratio (aOR) range: 1.28-1.94], receipt of psychotropic medication prescriptions (aOR range: 1.23-2.69) and having a prior year emergency department visit (aOR = 1.32) or inpatient psychiatric admission (aOR = 2.15).

Conclusions: Among VHA patients who experienced MST, specific mental health conditions may increase risk of NFSAs, even after adjustment for overall mental health morbidity. Additionally, indicators of severity of mental health difficulties such as receipt of psychotropic medication prescriptions and inpatient psychiatric admissions are also associated with increased risk above and beyond risk associated with diagnoses. Findings highlight targets for suicide prevention initiatives among this vulnerable group within VHA and may help identify patients who would benefit from additional support.

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来源期刊
Suicide and Life-Threatening Behavior
Suicide and Life-Threatening Behavior Medicine-Public Health, Environmental and Occupational Health
CiteScore
5.40
自引率
3.10%
发文量
96
期刊介绍: An excellent resource for researchers as well as students, Social Cognition features reports on empirical research, self-perception, self-concept, social neuroscience, person-memory integration, social schemata, the development of social cognition, and the role of affect in memory and perception. Three broad concerns define the scope of the journal: - The processes underlying the perception, memory, and judgment of social stimuli - The effects of social, cultural, and affective factors on the processing of information - The behavioral and interpersonal consequences of cognitive processes.
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