Warzone experiences and subsequent clinician suicide risk assessment in veterans

Objective
To determine in veterans whether severity of combat exposure was predictive of subsequently receiving a suicide risk assessment (SRA), and whether this relationship was meditated by depression symptomatology.
Method
We conducted an electronic medical records review for SRA ratings of 486 veterans who had completed Combat Exposure Scale (CES) and Beck Depression Inventory-II (BDI-II) assessments in a study of Post-Deployment Mental Health (PDMH).
Results
Higher total scores on the CES and BDI-II were characteristic of PDMH participants who subsequently (mean 29.2 months later) received an SRA from a Veterans Health Administration provider. Among participants with an SRA, those scoring at high risk had significantly greater CES and BDI-II scores than those rated at low risk. Participants rated at low risk tended to have CES and BDI-II scores higher than those of participants for whom no SRA was found. Relationships between combat exposures and both performance of an SRA and the SRA risk level were mediated by BDI-II scores.
Conclusion
These data extend previous findings of depression-mediated linkages between warzone experiences and subsequent self-reported suicide risk among veterans, by indicating chronicity of combat trauma-related suicide risk and demonstrating a concordance between self-reported and clinician-reported suicidality as it relates to experiential and psychiatric factors.