Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Suicide and all-cause mortality in Swedish deployed military veterans: a population-based matched cohort study
Karolinska Institutet, Department of Medicine Solna, Clinical Epidemiology Unit.
Karolinska Institutet, Department of Medicine Solna, Clinical Epidemiology Unit.
Cyclo AB, Stockholm.
Karolinska Institutet, Department of Medicine Solna, Clinical Epidemiology Unit.
Show others and affiliations
2017 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 7, no 9, article id e014034Article in journal (Refereed) Published
Abstract [en]

Objective: To investigate suicide and mortality risk in deployed military veterans versus non-deployed comparators who had gone through military conscription testing.

Design: Population-based matched cohort study.

Setting: Sweden.

Participants: Participants were identified from the Military Service Conscription Register and deployment status from the Swedish Military Information Personnel Register. Of 1.9 million conscripts, 21 721 had deployed at some time between 1990 and 2013 (deployed military veterans). Non-deployed comparators were matched to deployed military veterans in two ways: (1) by cognitive ability, psychological assessment, mental health, body mass index, sex, birth-year and conscription-year (carefully matched), with further adjustment for exercise capacity and suicide attempt history; and (2) by sex, birth-year and conscription-year (age-and sex-matched).

Main outcome: Suicide retrieved from the Swedish National Patient and Causes of Death Register until 31 December 2013.

Results: During a median follow-up of 12 years, 39 and 211 deaths by suicide occurred in deployed military veterans (n=21 627) and carefully matched non-deployed comparators (n=107 284), respectively (15 vs 16/100 000 person-years; adjusted HR (aHR) 1.07; 95% CI 0.75 to 1.52; p=0.72) and 329 in age-and sex-matched non-deployed comparators (n=108 140; 25/100 000 person-years; aHR 0.59; 95% CI 0.42 to 0.82; p=0.002). There were 284 and 1444 deaths by suicide or attempted suicides in deployed military veterans and carefully matched non-deployed comparators, respectively (109 vs 112; aHR 0.99; 95% CI 0.88 to 1.13; p=0.93) and 2061 in age-and sex-matched non-deployed comparators (158; aHR 0.69; 95% CI 0.61 to 0.79; p<0.001). The corresponding figures for all-cause mortality for carefully matched non-deployed comparators were 159 and 820 (61 vs 63/100 000 person-years; aHR 0.97; 95% CI 0.82 to 1.15; p=0.71) and 1289 for age-and sex-matched non-deployed comparators (98/100 000 person-years; aHR 0.62; 95% CI 0.52 to 0.73; p<0.001).

Conclusion: Deployed military veterans had similar suicide and mortality risk as non-deployed comparators after accounting for psychological, psychiatric and physical factors. Studies of mental health in deployed veterans need to adjust for more factors than age and sex for comparisons to be meaningful.

Place, publisher, year, edition, pages
2017. Vol. 7, no 9, article id e014034
National Category
Public Health, Global Health, Social Medicine and Epidemiology Basic Medicine
Identifiers
URN: urn:nbn:se:uu:diva-337761DOI: 10.1136/bmjopen-2016-014034ISI: 000412650700010OAI: oai:DiVA.org:uu-337761DiVA, id: diva2:1173471
Note

Funding: Research reported in this publication was supported by Kungafonden (the Royal Fund). The content is solely the responsibility of the authors and does not necessarily represent the official views of the Royal Fund.

Available from: 2018-01-12 Created: 2018-01-12 Last updated: 2018-01-12Bibliographically approved

Open Access in DiVA

fulltext(1192 kB)22 downloads
File information
File name FULLTEXT01.pdfFile size 1192 kBChecksum SHA-512
81b6b9e51ba31f50be70dcd48af87bf082a6c6f778470186c30a3b240afd9a85221c7d33fa95639d234b2ded3134fbcffa55e06ea48eb51cc04c8259959e8f9a
Type fulltextMimetype application/pdf

Other links

Publisher's full text

Search in DiVA

By author/editor
Sundström, Johan
By organisation
Department of Medical Sciences
In the same journal
BMJ Open
Public Health, Global Health, Social Medicine and EpidemiologyBasic Medicine

Search outside of DiVA

GoogleGoogle Scholar
Total: 22 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
urn-nbn

Altmetric score

doi
urn-nbn
Total: 4 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf