Year: 2021 Source: AJP in AdvanceDOI: 10.1176/appi.ajp.2021.20111570 SIEC No: 20210687

Objective: The authors sought to identify predictors of imminent suicide attempt (within 30 days) among U.S. Army soldiers following their first documented suicidal ideation.
Methods: Using administrative data from the Army Study to
Assess Risk and Resilience in Servicemembers, the authors
identified 11,178 active-duty Regular Army enlisted soldiers
(2006–2009) with medically documented suicidal ideation
and no prior medically documented suicide attempts. The
authors examined risk factors for suicide attempt within
30 days of first suicidal ideation using logistic regression
analyses, including sociodemographic and service-related
characteristics, psychiatric diagnoses, physical health care
visits, injuries, and history of family violence or crime perpetration or victimization.
Results: Among soldiers with first documented suicidal ideation, 830 (7.4%) attempted suicide, 46.3% of whom
(N5387) attempted suicide within 30 days (rate, 35.4 per
1,000 soldiers). Following a series of multivariate analyses,
the final model identified females (odds ratio51.3, 95%
CI51.0, 1.8), combat medics (odds ratio51.6, 95% CI51.1,
2.2), individuals with an anxiety disorder diagnosis prior to
suicidal ideation (odds ratio51.3, 95% CI51.0, 1.6), and
those who received a sleep disorder diagnosis on the
same day as the recorded suicidal ideation (odds ratio52.3,
95% CI51.1, 4.6) as being more likely to attempt suicide
within 30 days. Black soldiers (odds ratio50.6, 95%
CI50.4, 0.9) and those who received an anxiety disorder
diagnosis on the same day as suicidal ideation (odds
ratio50.7, 95% CI50.5, 0.9) were less likely.
Conclusions: Suicide attempt risk is highest in the first
30 days following ideation diagnosis and is more likely
among women, combat medics, and soldiers with an anxiety disorder diagnosis before suicidal ideation and a sameday sleep disorder diagnosis. Black soldiers and those with a
same-day anxiety disorder diagnosis were at decreased risk.
These factors may help identify soldiers at imminent risk of
suicide attempt