Salud Mental

Suicidal ideation and suicide attempt in a clinical sample of Mexican naval military

##plugins.themes.bootstrap3.article.main##

René Ocampo-Ortega
Annel Noely Portillo-Wong

Abstract

Introduction. Suicide represents the sixteenth cause of death worldwide. Until a few years ago the suicide rate in the US military has been below that of the civilian population, but in 2008 the suicide rate among US soldiers began to outpace the civilian population. To our knowledge, there are no studies that describe suicidal behavior among Mexican military personnel.

Objective. To know the frequency of suicidal ideation and suicide attempt in the last 12 months in Mexican naval military and determine the variables associated with both ideation and suicide attempt.

Method. This cross-sectional study included 246 outpatients who were sent for psychiatric assessment from their operating units. A psychiatric interview was conducted using the diagnostic criteria of the International Classification of Diseases in its tenth edition, which included the presentation of suicidal ideation and attempted suicide in the last 12 months.

Results. Suicidal ideation in the last 12 months occurred in 60 cases (24.39%). Twenty-four cases (9.76%) presented a suicide attempt in the last 12 months. Variables associated with suicidal ideation were military grade (seaman and classes, p = .03), suicide family history (p < .01), depressive disorders (p < .01), and personality disorders (p < .01). Regarding the presentation of attempted suicide, the mean age in the cases was lower (p < .01). There was also a higher frequency of attempted suicide in singles or without a couple (p < .01), in personnel with four years or less in service (p < .01), and in patients with a personality disorder (p < .01).

Discussion and conclusion. Greater emphasis in the detection of mental health problems, including suicidality among the military population and more representative studies at the national level are needed.
Keywords:
Suicide, suicidal ideation, suicide attempt, risk factors, mental disorders, military

References

Blais, M. A., Smallwood, P., Groves, J. E., Rivas-Vazquez, R. A., & Hopwood, C. J. (2016). Personality and Personality Disorders. In Stern, T. A., Fava, M., Wilens, T. E., & Rosenbaum, J. F. (Eds.) Massachusetts General Hospital Comprehensive Clinical Psychiatry, (pp. 433-444). Boston, Massachusetts: Elsevier. ISBN: 978 0 323 29507 9

Bliese, P. D., Wright, K. M., Adler, A. B., Thomas, J. L., & Hoge, C. W. (2007). Timing of postcombat mental health assessments. Psychological Services, 4(3), 141-148. doi: 10.1037/1541-1559.4.3.141

Boden, M. T., Babdon, K. A., Vujanovic, A. A., Short, N. A., & Bon-Miller, M. O. (2013). Posttraumatic stress disorder and cannabis use characteristics among military veterans with cannabis dependence. The American Journal on Addictions, 22(3), 277-284. doi: 10.1111/j.1521-0391.2012.12018.x

Borges, G., Orozco R., Benjet, C., & Medina-Mora, M. E. (2010). Suicidio y conductas suicidas en México: retrospectiva y situación actual. Salud Pública de México, 52(4), 292-304.

Brendel, R. W., Brezing, C. A., Lagomasino, I. T., Perlis R. H., & Stern, T. A. (2016). The Suicidal Patient. In Stern, T. A., Fava, M., Wilens, T. E., & Rosenbaum, J. F. (Eds.) Massachusetts General Hospital Comprehensive Clinical Psychiatry, (pp. 589-598). Boston, Massachusetts: Elsevier. ISBN: 978 0 323 29507 9

Burnam, M. A., Meredith, L. S., Tanielian, T., & Jaycox, L. H. (2009). Mental health care for Iraq and Afghanistan war veterans. Health Affairs, 28(3), 771-782. doi: 10.1377/hlthaff.28.3.771

Castro, C. A., & Kintzle, S. (2014). Suicides in the military: The post-modern combat veteran and the Hemingway effect. Current Psychiatry Reports, 16(8), 460. doi: 10.1007/s11920-014-0460-1

Diario Oficial de la Federación. (2013). Programa Sectorial de Marina 2013-2018. Retrieved from: http://www.dof.gob.mx/nota_detalle.php?codigo=5326470&fecha=16/12/2013

Drummet, A. R., Coleman, M., & Cable, S. (2003). Military families under stress: Implications for family life education. Family Relations, 52(3), 279-287. doi: 10.1111/j.1741-3729.2003.00279.x

Hawton, K., Houston, K., Haw, C., Townsend, E., & Harris, L. (2003). Comorbidity of axis I and axis II disorders in patients who attempted suicide. American Journal of Psychiatry, 160(8), 1494-1500. doi: 10.1176/appi.ajp.160.8.1494

Hoge, C. W., Castro, C. A., Messer, S. C., McGurk, D., Cotting, D. I., & Koffman, R. L. (2004). Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. The New England Journal of Medicine, 351(1), 13-22. doi: 10.1056/NEJMoa040603

Hoge, C. W., Grossman, S. H., Auchterlonie, J. L., Riviere, L. A., Milliken, C. S., & Wilk, J. E. (2014). PTSD treatment for soldiers after combat deployment: Low utilization of mental health care and reasons for dropout. Psychiatric Services, 65(8), 997-1004. doi: 10.1176/appi.ps.201300307

Hong, V. (2016). Borderline personality disorder in the emergency department: good psychiatric management. Harvard Review Psychiatry, 24(5), 357-366. doi: 10.1097/HRP.0000000000000112

Kuehn, B. M. (2009). Soldier suicide rates continue to rise: military, scientists work to stem the tide. JAMA, 301(11), 1111-1113. doi: 10.1001/jama.2009.342

LeardMann, C. A., Powell, T. M., Smith, T. C., Bell, M. R., Smith, B., Boyko, E. J., ... Hoge, C. W. (2013). Risk factors associated with suicide in current and former US military personnel. JAMA, 310(5), 496-506. doi: 10.1001/jama.2013.65164

Moukaddam, N., Flores, A., Matorin, A., Hayden, N., & Tucci, V. T. (2017). Difficult patients in the emergency department, personality disorders and beyond. Psychiatric Clinics of North America, 40(3), 379-395. doi: 10.1016/j.psc.2017.05.005

Naifeh, J. A., Colpe, L. J., Aliaga, P. A., Sampson N. A., Heeringa S. G., Stein M. B., ... Kessler, R. C. (2016). Barriers to initiating and continuing mental health treatment among soldiers in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). Military Medicine, 181(9), 1021-1032. doi: 10.7205/MILMED-D-15-00211

Nock, M. K., Deming, C. A., Fullerton, C. S., Gilman, S. E., Goldenberg, M., Kessler, R.C., ... Ursano, R. J. (2013). Suicide among soldiers: A review of psychosocial risk and protective factors. Psychiatry: Interpersonal & Biological Processes, 76(2), 97-125. doi: 10.1521/psyc.2013.76.2.97

Nock, M. K., Stein, M. B., Heeringa, S. G., Ursano, R. J., Colpe, L. J., Fullerton, C. S., … Kessler, R. C. (2014). Prevalence and correlates of suicidal behavior among soldiers: Results from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). JAMA Psychiatry, 71(5), 514-22. doi: 10.1001/jamapsychiatry.2014.30

Olfson, M., Blanco, C., Wall, M., Liu, S., Saha, T. D., Pickering, R. P., & Grant, B. F. (2017). National trends in suicide attempts among adults in the United States. JAMA Psychiatry, 74(11), 1095-1103. doi: 10.1001/jamapsychiatry.2017.2582

Reger, M. A., Smolenski, D. J., Skopp, N. A., Metzger-Abamukang, M. J., Kang, H. K., Bullman, T. A., ... Gahm, G. A. (2015). Risk of suicide among US military service members following Operation Enduring Freedom or Operation Iraqi Freedom deployment and separation from the US Military. JAMA Psychiatry, 72(6), 561-569. doi: 10.1001/jamapsychiatry.2014.3195

Rosellini, A. J., Heeringa, S. G., Stein, M. B., Ursano, R. J., Chiu, W. T., Colpe, L. J., ... Kessler R. C. (2014). Lifetime prevalence of DSM-IV mental disorders among new soldiers in the U.S. Army: results from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). Depression and Anxiety, 32(1), 13-24. doi: 10.1002/da.22316

Schoenbaum, M., Kessler, R. C., Gilman, S. E., Colpe, L. J., Heeringa, S. G., Stein, M. B., ... Cox, K. L. (2014). Predictors of suicide and accident death in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS): Results from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). JAMA Psychiatry, 71(5), 493-503. doi: 10.1001/jamapsychiatry.2013.4417

Street, A. E., Gilman, S. E., Rosellini, A. J., Stein, M. B., Bromet, E. J., Cox, K. L., ... Kessler R. C. (2015). Understanding the elevated suicide risk of female soldiers during deployments. Psychological Medicine, 45(4), 717-726. doi: 10.1017/S003329171400258X

Thomas, J. L., Adrian, A. L., Penix, E. A., Wilk, J. E., & Adler A. B. (2016). Mental health literacy in U.S. soldiers: Knowledge of services and processes in the utilization of military mental health care. Military Behavioral Health, 4(2), 92-99. doi: 10.1080/21635781.2016.1153541

Ursano, R. J., Heeringa, S. G., Stein, M. B., Jain, S., Raman, R., Sun, X., ... Kessler, R. C. (2015a). Prevalence and correlates of suicidal behavior among new soldiers in the US Army: results from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). Depression and Anxiety, 32(1), 3-12. doi: 10.1002/da.22317

Ursano, R. J., Kessler, R. C., Naifeh, J. A., Herberman Mash, H., Nock, M. K., Aliaga, P. A., ... Stein, M. B. (2018). Risk factors associated with attempted suicide among US Army soldiers without a history of mental health diagnosis. JAMA Psychiatry, 75(10), 1022-1032. doi: 10.1001/jamapsychiatry.2018.2069

Ursano, R. J., Kessler, R. C., Naifeh, J. A., Herberman-Mash, H., Fullerton, C. S., Bliese, P. D., ... Stein, M. B. (2017). Risk of suicide attempt among soldiers in army units with a history of suicide attempts. JAMA Psychiatry, 74(9), 924-931. doi: 10.1001/jamapsychiatry.2017.1925

Ursano, R. J., Kessler, R. C., Stein, M. B., Naifeh, J. A., Aliaga, P. A., Fullerton, C. S., ... Heeringa, S. G. (2015b). Suicide attempts in the US Army during the wars in Afghanistan and Iraq, 2004 to 2009. JAMA Psychiatry, 72(9), 917-926. doi: 10.1001/jamapsychiatry.2015.0987

Warner, C. H., Appenzeller, G. N., Grieger, T., Belenkiy, S., Breitbach, J., Parker, J., ... Hoge, C. (2011). Importance of anonymity to encourage honest reporting in mental health screening after combat deployment. Archives of General Psychiatry, 68(10), 1065-1071. doi: 10.1001/archgenpsychiatry.2011.112

West, J. C., Wilk, J. E., Duffy, F. F., Kuramoto, S. J., Rae, D. S., Mościcki, E. K., & Hoge, C. W. (2014). Mental health treatment access and quality in the Army: Survey of mental health clinicians. Journal of Psychiatric Practice, 20(6), 448-459. doi: 10.1097/01.pra.0000456593.58739.61

World Health Organization. (2000). Preventing suicide. A resource for general physicians. (No. WHO/MNH/MBD/00.1). World Health Organization. Retrieved from: http://apps.who.int/iris/bitstream/handle/10665/67165/WHO_MNH_MBD_00.1.pdf;jsessionid=3018B0C24765A54318B973E81920A528?sequence=1