Risk factors for suicide attempt among Israeli Defense Forces soldiers: A retrospective case-control study

Résumé

textbfBACKGROUND: A major risk factor for suicide is suicide attempts. The aim of the present study was to assess risk factors for nonfatal suicide attempts. textbfMETHODS: The study's cohort consisted of 246,814 soldiers who were divided into two groups: soldiers who made a suicide attempt (n=2310; 0.9%) and a control group of soldiers who did not (n=244,504; 99.1%). Socio-demographic and personal characteristics as well as psychiatric diagnoses were compared. textbfRESULTS: The strongest risk factors for suicide attempt were serving less than 12 months (RR=7.09) and a history of unauthorized absence from service (RR=5.68). Moderate risk factors were low socioeconomic status (RR=2.17), psychiatric diagnoses at induction (RR=1.94), non-Jewish religion (RR=1.92), low intellectual rating score (RR=1.84), serving in non-combat unit (RR=1.72) and being born in the former Soviet Union (RR=1.61). A weak association was found between male gender and suicide attempt (RR=1.36). Soldiers who met more frequently with a primary care physician (PCP) had a higher risk for suicide attempt, as opposed to a mental health professional (MHCP), where frequent meetings were found to be a protective factor (Ptextless0.0001). The psychiatric diagnoses associated with a suicide attempt were a cluster B personality disorder (RR=3.00), eating disorders (RR=2.78), mood disorders (RR=2.71) and adjustment disorders (RR=2.26). textbfLIMITATIONS: Mild suicidal behavior constitutes a much larger proportion than among civilians and may have secondary gain thus distorting the suicidal behavior data. textbfCONCLUSIONS: Training primary care physicians as gatekeepers and improved monitoring, may reduce the rate of suicide attempts. ISRAËL PROCHE-ORIENT GENRE HOMME FEMME TENTATIVE SUICIDE-COMPLÉTÉ DÉPISTAGE POTENTIEL-SUICIDAIRE RÉCIDIVE FACTEUR-RISQUE MILITAIRE PSYCHOPATHOLOGIE FACTEUR-SOCIODÉMOGRAPHIQUE