Predicting Suicides After Psychiatric Hospitalization in US Army Soldiers

作者：Ronald C. Kessler, Christopher H. Warner, Christopher Ivany, Maria V. Petukhova, Sherri Rose, Evelyn J. Bromet, Millard D. Brown, Tianxi Cai, Lisa J. Colpe, Kenneth L. Cox, Carol S. Fullerton, Stephen E. Gilman, Michael J. Gruber, Steven G. Heeringa, Lisa Lewandowski‐Romps, Junlong Li, Amy M. Millikan-Bell, James A. Naifeh, Matthew K. Nock, Anthony J. Rosellini, Nancy A. Sampson, Michael Schoenbaum, Murray B. Stein, Simon C. Wessely, Alan M. Zaslavsky, Robert J. Ursano · 发表于：JAMA Psychiatry · 年份：2014 · DOI：10.1001/jamapsychiatry.2014.1754 · 被引用次数：459 · 研究领域：Suicide and Self-Harm Studies、Posttraumatic Stress Disorder Research、Gun Ownership and Violence Research

IMPORTANCE: The US Army experienced a sharp increase in soldier suicides beginning in 2004. Administrative data reveal that among those at highest risk are soldiers in the 12 months after inpatient treatment of a psychiatric disorder. OBJECTIVE: To develop an actuarial risk algorithm predicting suicide in the 12 months after US Army soldier inpatient treatment of a psychiatric disorder to target expanded posthospitalization care. DESIGN, SETTING, AND PARTICIPANTS: There were 53,769 hospitalizations of active duty soldiers from January 1, 2004, through December 31, 2009, with International Classification of Diseases, Ninth Revision, Clinical Modification psychiatric admission diagnoses. Administrative data available before hospital discharge abstracted from a wide range of data systems (sociodemographic, US Army career, criminal justice, and medical or pharmacy) were used to predict suicides in the subsequent 12 months using machine learning methods (regression trees and penalized regressions) designed to evaluate cross-validated linear, nonlinear, and interactive predictive associations. MAIN OUTCOMES AND MEASURES: Suicides of soldiers hospitalized with psychiatric disorders in the 12 months after hospital discharge. RESULTS: Sixty-eight soldiers died by suicide within 12 months of hospital discharge (12.0% of all US Army suicides), equivalent to 263.9 suicides per 100,000 person-years compared with 18.5 suicides per 100,000 person-years in the total US Army. The strongest pr...