@article{ref1,
title="Suicidal ideation, behavior, and mortality in male and female US veterans with severe mental illness",
journal="Journal of affective disorders",
year="2020",
author="Aslan, Mihaela and Radhakrishnan, Krishnan and Rajeevan, Nallakkandi and Sueiro, Melyssa and Goulet, Joseph L. and Li, Yuli and Depp, Colin and Concato, John and Harvey, Philip D.",
volume="267",
number="",
pages="144-152",
abstract="BACKGROUND: We compared male and female American veterans with schizophrenia or bipolar disorder regarding clinical characteristics associated with lifetime suicidal ideation and behavior. Subsequent mortality, including death by suicide, was also assessed. <br><br>METHODS: Data from questionnaires and face-to-face evaluations were collected during 2011-2014 from 8,049 male and 1,290 female veterans with schizophrenia or bipolar disorder. In addition to comparing male-female characteristics, Cox regression models-adjusted for demographic information, medical-psychiatric comorbidities, and self-reported suicidal ideation and behavior-were used to examine gender differences in associations of putative risk factors with suicide-specific and all-cause mortality during up to six years of follow-up. <br><br>RESULTS: Women overall were younger, more likely to report a history of suicidal behavior, less likely to be substance abusers, and had lower overall mortality during follow-up. Among women only, psychiatric comorbidity was paradoxically associated with lower all-cause mortality (hazard ratio [HR]=0.53, 95% CI, 0.29-0.96, p = 0.037 for 1 disorder vs. none; HR=0.44, 95% CI, 0.25-0.77, p = 0.004 for ≥2 disorders vs. none). Suicide-specific mortality involved relatively few events, but crude rates were an order of magnitude higher than in the U.S. general and overall veteran populations. LIMITATIONS: Incomplete cause-of-death information and low statistical power for male-female comparisons regarding mortality. <br><br>CONCLUSIONS: Female veterans with SMI differed from females in the general population by having a higher risk of suicide attempts. They also had more lifetime suicide attempts than male veterans with same diagnoses. These differences should inform public policy and clinical planning.<br><br>Published by Elsevier B.V.<p /> <p>Language: en</p>",
language="en",
issn="0165-0327",
doi="10.1016/j.jad.2020.02.022",
url="http://dx.doi.org/10.1016/j.jad.2020.02.022"
}