Among US soldiers, the risk for suicide attempt is highest within 30 days of suicidal ideation diagnosis, according to study findings published in The American Journal of Psychiatry.

“Although the majority of soldiers who attempt suicide have no history of administratively documented ideation, there is a significant minority whose suicidal thoughts are diagnosed prior to their attempt,” wrote researchers from the Uniformed Services University of the Health Sciences. “This group is particularly important to the health care system as they fall within the purview of clinicians who assess suicide risk and deliver evidence-based treatments.”

The study looked at predictors of imminent suicide attempt among 11 178 active-duty soldiers in the US Army with medically documented suicidal ideation. Among them, 7.4% went on to attempt suicide, 46.3% of whom did so within 30 days of suicidal ideation diagnosis. Altogether, more than 3.5% of soldiers with suicidal ideation attempted suicide within 30 days of diagnosis.

Over time, the risk of suicide attempt decreased, the study showed, suggesting the initial 30-day window is a time of particularly high risk.

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Multivariate analyses revealed that women, combat medics, soldiers with a previous anxiety disorder diagnosis, and soldiers diagnosed with a sleep disorder the same day their suicidal ideation was diagnosed were at increased risk of suicide attempt within 30 days compared with other soldiers. Meanwhile, Black soldiers and soldiers diagnosed with an anxiety disorder the same day their suicidal ideation was diagnosed were at lower risk of suicide attempt.

Posttraumatic stress disorder was not associated with heightened suicide attempt within 30 days, according to the study.

More than half of soldiers with suicidal ideation in the study had less than 2 years of service, and nearly 57.7% were never deployed.

“Identifying suicide risk is challenging and raises many questions, but these findings are critically important to answering some of our most challenging questions,” said study senior author Robert Ursano, MD. “Knowing the who, the when, and the where of suicide risk is one of the best ways we can target interventions.”

References

Mash HBH, Ursano RJ, Kessler RC, et al. Predictors of suicide attempt within 30 days after first medically documented suicidal ideation in U.S. Army soldiers. Am J Psychiatry. Published online September 1, 2021. doi: 10.1176/appi.ajp.2021.20111570

In soldiers, risk for suicide attempt is highest 30 days after suicidal thoughts. News release. Uniformed Services University of the Health Sciences (USU). August 30, 2021. Accessed September 7, 2021.