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Suicides Among Depressed Veterans
The largest and most up-to-date study of suicides among depressed veterans provides important new data that may help guide screening and treatment for all veterans.
Investigators in the Department of Veterans Affairs National Serious Mental Illness Treatment Research and Evaluation Center (SMITREC) and the VA’s Health Services Research and Development Center of Excellence in Ann Arbor, Michigan recently published a paper in the American Journal of Public Health examining suicide rates using data from the VA’s National Registry for Depression for 807,694 veterans of all ages diagnosed with depression and treated at any Veterans Affairs facility between 1999 and 2004. In all, 1,683 of veterans in VA depression treatment died by suicide during the study observation period, representing 0.21 percent of this treatment population, approximately 7-8 times greater than the suicide rate in the general adult US population.
Typically, people in the general population who die by suicide are older, male, and white, and have depression and medical or substance abuse issues. In this study, we too found that depressed veterans who had substance abuse problems or a psychiatric hospitalization in the year prior to their index depression diagnosis had higher suicide rates. However, when we divided depressed veterans into three age groups: 18 to 44 years, 45 to 64 years, and 65 years or older, we found that the younger veterans were at the highest risk for suicide.
Surprisingly, our initial findings revealed a lower suicide rate among depressed veterans who also had a diagnosis of post-traumatic stress disorder (PTSD) compared to depressed veterans without this disorder. We found that concurrent PTSD was more closely associated with lower suicide rates among older veterans rather than among younger veterans.
This study does not reveal a reason for this lower suicide rate, but we hypothesize that it may be due to the high level of attention paid to PTSD treatment in the VA system, and the greater likelihood that patients with both depression and PTSD will receive psychotherapy and more intensive visits.
Zivin K, Kim HM, McCarthy JF, et al. Suicide Mortality Among Individuals Receiving Treatment for Depression in the Veterans Affairs Health System: Associations with Patient and Treatment Setting Characteristics. American Journal of Public Health. Dec 2007;97(12):2193-2198.