Predictors of suicide attempt within 30 days of first medically documented major depression diagnosis in U.S. army soldiers with no prior suicidal ideation

Mash, Holly B. Herberman; Ursano, Robert J.; Kessler, Ronald C.; Naifeh, James A.; Fullerton, Carol S.; Aliaga, Pablo A.; Dinh, Hieu M.; Sampson, Nancy A.; Kao, Tzu-Cheg; Stein, Murray B.

doi:10.1186/s12888-023-04872-z

Table 2 Association of psychiatric diagnoses of active-duty Regular U.S. Army enlisted soldiers with documented suicide attempt within 30 days following initial major depression diagnosis

From: Predictors of suicide attempt within 30 days of first medically documented major depression diagnosis in U.S. army soldiers with no prior suicidal ideation

		Univariable			Multivariable^c		Soldiers with Major Depression Diagnosis with No SI				Total population (n = 101,046)
							Attempt suicide within 30 days^a (n = 421)		Did not attempt suicide within 30 days^b (n = 100,625)
	χ²	OR^d	(95% CI^d)	χ²	OR	(95% CI)	n	%	n	%	%
Psychiatric Diagnosis
Adjustment Disorder (Day of depression diagnosis)
Yes		2.1*	(1.4–3.1)		1.6*	(1.1–2.4)	26	6.2	3,119	3.1	3.1
No		1.0	–		1.0	–	395	93.8	97,506	96.9	96.9
	12.57*			5.39*
Alcohol Use Disorder (Day of depression diagnosis)
Yes		1.9*	(1.3–2.6)		1.7*	(1.2–2.4)	40	9.5	5,380	5.3	5.4
No		1.0	–		1.0	–	381	90.5	95,245	94.7	94.6
	13.94*			10.36*
Alcohol Use Disorder (Prior to depression diagnosis)
Yes		1.4*	(1.1–1.8)		1.5*	(1.2–2.0)	74	17.6	13,461	13.4	13.4
No		1.0	–		1.0	–	347	82.4	87,164	86.6	86.6
	6.41*			9.85*
Anxiety Disorders (Day of depression diagnosis)
Yes		1.3*	(1.0–1.7)		1.4*	(1.1–1.7)	93	22.1	17,992	17.9	17.9
No		1.0	–		1.0	–	328	77.9	82,633	82.1	82.1
	5.21*			6.50*
Anxiety Disorders (Prior to depression diagnosis)
Yes		0.7*	(0.6–0.9)		1.0	(0.8–1.2)	142	33.7	41,470	41.2	41.2
No		1.0	–		1.0	–	279	66.3	59,155	58.8	58.8
	9.24*			0.00
Bipolar Disorder (Day of depression diagnosis)
Yes		7.1*	(3.6–13.8)		5.3*	(2.7–10.4)	9	2.1	307	0.3	0.3
No		1.0	–		1.0	–	412	97.9	100,318	99.7	99.7
	32.71*			23.43*
Dysthymic Disorder/Neurasthesia/ Depression NOS (Day of depression diagnosis)
Yes		2.4*	(1.7–3.4)		1.8*	(1.3–2.5)	38	9.0	3,950	3.9	3.9
No		1.0	–		1.0	–	383	91.0	96,675	96.1	96.1
	26.87*			11.90*
Stressors/Adversities & Marital Problems (Day of depression diagnosis)
Yes		1.4*	(1.0–1.8)		1.3*	(1.0–1.8)	60	14.3	10,831	10.8	10.8
No		1.0	–		1.0	–	361	85.7	89,794	89.2	89.2
	5.32*			4.36*
Stressors/Adversities & Marital Problems (Prior to depression diagnosis)
Yes		0.7*	(0.6–0.8)		1.0	(0.8–1.2)	157	37.3	46,943	46.7	46.6
No		1.0	–		1.0	–	264	62.7	53,682	53.3	53.4
	14.08*			0.01
Non-Affective Psychosis (Day of depression diagnosis)
Yes		3.5*	(1.8–6.7)		2.6*	(1.3–5.0)	9	0.2	633	0.6	0.6
No		1.0	–		1.0	–	412	97.9	99,992	99.4	99.4
	13.39*			7.60*
Other Diagnosis (Day of depression diagnosis)^e
Yes		10.3*	(7.3–14.5)		7.0*	(4.9–9.9)	37^e	8.8	932	0.9	1.0
No		1.0	–		1.0	–	384	91.2	99,693	99.1	99.0
	176.84*			118.47*
Personality Disorder (Day of depression diagnosis)
Yes		4.3*	(2.2–8.3)		3.2*	(1.7–6.3)	9	0.2	510	0.5	0.5
No		1.0	–		1.0	–	412	97.9	100,115	99.5	99.5
	18.28*			11.78*
Sexual Disorder (Prior to depression diagnosis)
Yes		0.2*	(0.1–0.5)		0.6	(0.2–1.5)	4	1.0	4,671	4.6	4.6
No		1.0	–		1.0	–	417	99.0	95,954	95.4	95.4
	10.38*			0.13
Sleep Disorder (Day of depression depression)
Yes		0.3*	(0.1–0.8)		0.4*	(0.1–1.0)	4	1.0	3,028	3.0	3.0
No		1.0	–		1.0	–	417	99.0	97,597	97.0	97.0
	5.49*			3.95*
Sleep Disorder (Prior to depression diagnosis)
Yes		0.7*	(0.6–1.0)		1.2	(0.9–1.6)	52	12.4	16,110	16.0	16.0
No		1.0	–		1.0	–	369	87.6	84,515	84.0	84.0
	4.05*			0.99
Somatoform/Dissociative Disorder (Prior to depression diagnosis)
Yes		1.1	(0.7–1.8)		1.7*	(1.0–2.8)	17	4.0	3,768	3.7	3.7
No		1.0	–		1.0	–	404	96.0	96,857	96.3	96.3
	0.10			4.60*
Tobacco Use Disorder (Day of depression diagnosis)
Yes		1.7*	(1.2–2.4)		1.7*	(1.2–2.3)	41	9.7	5,949	5.9	5.9
No		1.0	–		1.0	–	380	90.3	94,676	94.1	94.1
	10.82*			9.18*
Traumatic Stress (Day of depression diagnosis)
Yes		3.3*	(1.8–6.0)		2.9*	(1.6–5.2)	11	2.6	817	0.8	0.8
No		1.0	–		1.0	–	410	97.4	99,808	99.2	99.2
	14.76*			11.46*
PTSD (Prior to depression diagnosis)
Yes		0.7*	(0.5–0.9)		1.2	(0.9–1.7)	43	10.2	14,602	14.5	14.5
No		1.0	–		1.0	–	378	89.8	86,023	85.5	85.5
	6.05*			1.52
Drug Induced Mental Disorder (Day of depression diagnosis)
Yes		2.6*	(1.1–6.2)		2.0	(0.8–4.9)	5	1.2	467	0.5	0.5
No		1.0	–		1.0	–	416	98.8	100,158	99.5	99.5
	4.35*			2.30
Drug Induced Mental Disorder (Prior to depression diagnosis)
Yes		1.5	(0.9–2.5)		1.7*	(1.0–2.9)	16	3.8	2,512	2.5	2.5
No		1.0	–		1.0	–	405	96.2	98,113	97.5	97.5
	2.83			4.39*
Non-Dependent Drug Abuse (Day of depression diagnosis)
Yes		2.3*	(1.3–4.2)		1.6	(0.9–3.0)	11	2.6	1,152	1.1	1.2
No		1.0	–		1.0	–	410	97.4	99,473	98.9	98.8
	7.41*			2.50

^aCases: Soldiers with first-time documented major depression with no prior suicidal ideation who subsequently attempted suicide within the next 30 days of recorded depression diagnosis
^bControls: Soldiers with first-time documented major depression with no prior suicidal ideation who did not subsequently attempt suicide within the next 30 days
^cEach variable was examined in a separate multivariable model that adjusted for socio-demographics (gender, current age, race, education, and marital status) and service-related characteristics (age at entry into Army service, time in service, deployment status, delayed promotion, demotion, and military occupation)
^dOR = Odds ratio; CI = Confidence interval
^eAmong soldiers who were diagnosed with a disorder classified as “Other,” 33/37 (89.2%) were identified by the ICD-9-CM code 300.9 (Unspecified nonpsychotic mental disorder)
*p < .05

Back to article page

ISSN: 1471-244X

Contact us

Submission enquiries: bmcpsychiatry@biomedcentral.com
General enquiries: ORSupport@springernature.com

BMC Psychiatry

Contact us