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Daniel E.
Study Looks at Suicide in Veterans - New York Times

Published: October 30, 2007

Veterans receiving treatment for depression are no more likely to take their own lives than civilian patients, according to a large Veterans Affairs study published this afternoon.

The study, a joint effort between the University of Michigan and the veterans’ agency that included detailed records from more than 800,000 veterans, is the largest and most comprehensive in this group of patients and the first to include troops returning from Iraq and Afghanistan.

It found 1,683 suicides in all, a rate of less than one-quarter of 1 percent — far lower than some previous estimates. But experts cautioned against applying the findings too widely, because most former servicemen and women with mental problems do not seek treatment in the Veterans Affairs system.

In contrast to most studies of nonveterans, which have found that the risk generally increases with age, the rate among the veterans was highest between the ages of 18 and 44, dropped about 20 percent among those between 45 and 64, and then rose again in later years.

Paradoxically, veterans who had post-traumatic stress symptoms, as well as depression, were at significantly lower risk than those without trauma symptoms, the study found. Veterans being treated for both conditions were 20 percent less likely to commit suicide than those who were treated for depression alone. People suffering from two conditions are usually considered to be at greater risk than those with just one.

“It may be that those being treated for P.T.S.D. have more access to services, more psychotherapy visits, just more mental health services in general,” said the study’s senior author, Dr. Marcia Valenstein of the University of Michigan and the veterans’ agency.

Dr. Valenstein added that the veterans being treated for post-traumatic stress were more likely than the others to receive income supplements from the government to cover the disability, which could also help account for the difference.

The Defense and Veterans Affairs Departments have been investigating suicide risk closely since a study of combat troops in 2003 found high rates of suicide. Another recent study, of veterans of Vietnam, World War II and other previous wars, found that veterans were about twice as likely to kill themselves as citizens who had not served in the military.

The new analysis focused only on those veterans who sought treatment for depression in the government’s health care system, and it suggested that they may be different in some ways from others in treatment.

“This is an important study and adds a lot to what we know about this population, veterans who seek treatment at the V.A. system,” said Mark Kaplan, a professor of community health at Portland State University.

In the study, Kara Zivin, a psychiatric researcher at the University of Michigan and the veterans’ agency, led a research team that evaluated records for 807,694 veterans treated in the system between April 1999 and September 2004. The group included men and women who had served in Vietnam, the Gulf War, Iraq and Afghanistan, though the researchers did not do separate analysis for each conflict.

The study did not evaluate the methods used in the suicides, which could also account from some differences between veterans and nonveterans. In the study among veterans living in the community published last summer, which was led by Dr. Kaplan, more than 80 percent of the suicides were committed with a gun. The rate in nonveterans was 55 percent.
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