Assessment of a Risk Index for Suicide Attempts Among US Army Soldiers With Suicide Ideation: Analysis of Data From the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS).

摘要: Importance The Department of Veterans Affairs recently began requiring annual suicide ideation (SI) screening all patients and additional structured questions for reporting SI. Related changes are under consideration at the Defense. These will presumably lead to higher SI detection, which require hiring clinical staff and/or developing a decision support system focus in-depth risk assessments on considered high risk. Objective To carry out proof-of-concept study whether brief question battery from survey US Army soldiers can help target by identifying with self-reported lifetime who highest subsequent administratively recorded nonfatal attempts (SAs). Design, Setting, Participants Cohort prospective observational design. Data were collected May 2011 February 2013. followed up through December 2014. Analyses conducted March November 2018. A logistic regression model was used assess SAs. total 3649 Regular in 3 Study Assess Risk Resilience Servicemembers (Army STARRS) surveys reported 18 45 months baseline Main Outcomes Measures Outcome SAs between response Predictors variables. Results respondents 80.5% male had median (interquartile range) age 29 (25-36) years (range, 18-55 years); 69.4% white non-Hispanic, 14.6% black, 9.0% Hispanic, 7.0% another racial/ethnic group. Sixty-five One respondent died without making SA but excluded analysis based previous evidence that predictors different death Significant factors recency (odds ratio [OR], 7.2; 95% CI, 2.9-18.0) persistence (OR, 2.6; 1.0-6.8), positive screens mental disorders 26.2; 6.1-112.0), career characteristics (OR junior enlisted rank, 30.0; 3.3-272.5 OR senior 6.7; 0.8-54.9). Cross-validated area curve 0.78. 10% estimated accounted 39.2% Conclusions Relevance suggest feasibility clinically useful index among using small number self-report questions. If implemented, continuous quality improvement approach should be taken refine series.