Trauma diagnoses and risk for suicide mortality in a health system patient population [abstract] Abstract uri icon
  • Background: Strong evidence exists for posttraumatic stress disorder (PTSD) as a risk factor for suicidal thoughts and behaviors. PTSD also has been identified as a serious risk factor for suicide mortality in U.S. veteran populations and in a Danish epidemiological sample. However, limited empirical studies examine PTSD and other trauma disorders as risk factors for suicide mortality, particularly among non-veteran health system patients in the United States. Additionally, this study further contributes to the field by considering a wider spectrum of trauma conditions (not isolated to the single diagnosis of PTSD) as risk factors for suicide mortality by including other trauma- and stressrelated diagnostic conditions (ie, acute stress disorder and other reactions to stress disorders [ICD-9 diagnostic codes 309.89, 309.9, 309.0–4, 309.82, and 309.83]).
    Methods: Using a case-control matched design, this study uses a dataset consisting of health plan-affiliated patients who died by suicide between 2000 and 2015 from 9 different U.S. health systems through participation in the Mental Health Research Network. Patients with PTSD (n=120), acute stress disorder (n=84), and other reactions to stress disorders (n=331) who died by suicide were case-matched by time period and site to a sample of controls (n=1592, n=2218, and n=8174, respectively). Patients were identified as having a trauma condition utilizing ICD-9 diagnostic codes (recorded in the electronic medical records and/or insurance claims data) at all participating health systems. Results: Adjusting for age and gender, individuals with diagnosed PTSD were more likely to die by suicide (3.6% vs 0.5%; adjusted odds ratio [aOR]: 10.10, 95% CI: 8.31–12.27). Patients with diagnosed acute stress disorder (2.5% vs 0.7%; aOR: 4.49, 95% CI: 3.58–5.62) and those diagnosed with other stress reactions (9.9% vs 2.4%; aOR: 5.38, 95% CI: 4.78–6.06) also were more likely to die by suicide.
    Conclusion: This study suggests that both PTSD and other trauma disorders in health system patient populations are serious risk factors for suicide mortality. These findings highlight the importance of population-level screening (ie, across health systems) to identify individuals with trauma diagnoses as well as providing and expanding trauma-informed mental health services in a suicide prevention strategy.

  • Link to Article
    publication date
  • 2021
  • Research
  • Mental Health
  • Mortality
  • Prevention
  • Risk Factors
  • Screening
  • Suicide
  • Additional Document Info
  • 8
  • issue
  • 2 Suppl