In recent years, suicide has become one of the leading causes of death in the U.S. military. Beginning at a baseline rate of 10.3 to 11.3 per 100,000 persons in 2005, the rate escalated to 16.3 per 100,000 persons in 2008, with the highest rates among Marine Corps and Army personnel: 19.9 and 19.3 per 100,000 persons.

In a recent study conducted by the Navy Bureau of Medicine and Surgery, researchers explored their rising concerns about suicide in the U.S. Military. Because the number of suicides sharply increased beginning in 2005, researchers worried (and more or less assumed) that combat deployments as well as other stressors unique to military life might have caused the increase.

The researchers understood, though, that flaws existed in the methodology of previous studies of military suicide. For instance, the studies were not longitudinal and failed to link data obtained during service with post-service data. Data from a longitudinal study, though, would allow the researchers to include demographic, military, mental health, behavioral, and deployment characteristics in their analysis and so facilitate their identification of risk factors for suicide in both current and former military personnel.

Methods And Matter

The Millennium Cohort Study (MCS) is a project recommended by Congress in 1999 and sponsored by the Department of Defense. Conducted by the Naval Health Research Center in San Diego, the more than 150,000 participants are either current or former military personnel from all service branches, including active and Reserve/National Guard. The researchers, then, analyzed data obtained from MCS and compared it to the National Death Index and the Department of Defense Medical Mortality Registry.

They found that, through December 31, 2008, factors significantly associated with increased risk of suicide included male sex, depression, manic-depressive disorder, heavy or binge drinking, and alcohol-related problems. None of the deployment-related factors (combat experience, cumulative days deployed, or number of deployments) were associated with increased suicide risk in any of the models.

"Studies have shown a marked increase in the incidence of diagnosed mental disorders in active-duty service members since 2005, paralleling the incidence of suicide," the authors of the study wrote. "This suggests that the increased rate of suicide in the military may largely be a product of an increased prevalence of mental disorders in this population, possibly resulting from indirect cumulative occupational stresses across both deployed and home-station environments over years of war."

To prevent suicide, the researchers suggest screening for and also addressing mental health problems. They believe that suicide could potentially be reduced (by approximately 18 percent and 11 percent, respectively) by "preventing or eliminating alcohol-related problems and depression." Additionally, they recommend further research into the collection of risk factors that might lead to self-harm as well as studying the intervention mechanisms that may reduce or prevent suicidal behavior.

Another study derived from data accumulated by the MCS focuses on the mental health of military women who recently gave birth.

Depression

Postpartum depression is a common enough condition among new mothers; often, it results in negative consequences to the health of both mother and child. Yet, an investigation of maternal depression, especially among military mothers experiencing combat conditions, has yet to be conducted.

Researchers at the Naval Health Research Center wanted to understand how combat experience impacted the mental health of mothers. Specifically, they examined maternal depression among U.S. service women and how it related to deployment before or after childbirth. To better understand the factors involved when a mother struggled with maintaining her mental health, they pored over data from 1,660 female participants who gave birth during active duty service and completed baseline and follow-up questionnaires between 2001 and 2008.

The researchers found that military women who were deployed after childbirth into any kind of combat or combat-like experience were at increased risk for developing maternal depression after deployment. However, among those women who were deployed into combat or combat-like situations, mothers who gave birth did not have a significantly increased risk for depression when compared with those who had not given birth. The risk for depression, then, appears to be related to combat rather than childbirth.

Deployment before childbirth and deployment into military situations that did not involve combat, the researchers noted, did not increase the risk of postpartum depression.

 

Sources: Leardmann CA, Powell TM, Smith TC, et al. Risk Factors Associated With Suicide in Current and Former US Military Personnel. JAMA. 2013.

Nguyen S, Leardmann CA, Smith B, et al. Is military deployment a risk factor for maternal depression? Journal of Women's Health. 2013.