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Roles of physical and mental health in suicidal ideation in Canadian Armed Forces Regular Force veterans

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Abstract

OBJECTIVES: Suicide in recent veterans is an international concern. An association between mental disorders and suicide has been established, but less information is available about an association between physical health problems and suicide among veterans. This study extends this area of inquiry by examining the relationship of both physical and mental health problems with suicidal ideation in a representative national sample of Canadian veterans.

MÉTHODS: Subjects were a stratified random sample of 2,658 veterans who had been released from the Canadian Armed Forces Regular Force during 1998–2007 and had participated in the 2010 Survey on Transition to Civilian Life. Associations between physical and mental health and past-year suicidal ideation were explored in multivariate regression models using three measures of physical and mental health.

RESULTS: The prevalence of suicidal ideation was 5.8% (95% confidence interval [CI]: 5.0%–6.8%). After adjustment for covariates, ideation was associated with gastrointestinal disorders (adjusted odds ratio [AOR] 1.66, CI: 1.03–2.65), depression or anxiety (AOR 5.06, CI: 2.97–8.62) and mood disorders (AOR 2.91, CI: 1.67–5.07); number of physical (AOR 1.22, CI: 1.05–1.42) and mental conditions (AOR 2.32, CI: 2.01–2.68); and SF-12 Health Survey physical health (AOR 0.98, CI: 0.96-0.99 for each 1 point increase) and mental health (AOR 0.88, CI: 0.87–0.89).

CONCLUSIONS: Physical health was independently associated with suicidal ideation after adjustment for mental health status and socio-demographic characteristics. The findings underscore the importance of considering physical health in population-based suicide prevention efforts and in mitigating suicide risk in individual veterans.

Résumé

OBJECTIFS: Les suicides de militaires récemment démobilisés sont un enjeu international. On a établi une association entre les troubles mentaux et le suicide, mais on a moins d’information sur une association possible entre les problèmes de santé physique et le suicide chez les anciens combattants. Nous avons voulu élargir le champ de recherche en examinant la relation entre les troubles de santé physique et mentale et l’idéation suicidaire au sein d’un échantillon national représentatif d’anciens combattants canadiens.

MÉTHODE: Nos sujets étaient un échantillon aléatoire stratifié de 2 658 anciens combattants démobilisés de la force régulière des Forces canadiennes entre 1998 et 2007 et ayant participé à l’Enquête sur la transition à la vie civile de 2010. Nous avons analysé les associations entre la santé physique et mentale et l’idéation suicidaire au cours de l’année antérieure à l’aide de modèles de régression multivariés comportant trois indicateurs de santé physique et mentale.

RÉSULTATS: La prévalence de l’idéation suicidaire était de 5,8 % (intervalle de confiance de 95 % [IC]: 5,0–6,8). Compte tenu des covariables, l’idéation était associée aux troubles gastro-intestinaux (rapport de cotes ajusté [RCA] 1,66, IC: 1,03–2,65), à la dépression ou à l’anxiété (RCA 5,06, IC: 2,97-8,62) et aux troubles de l’humeur (RCA 2,91, IC: 1,67–5,07); au nombre de troubles physiques (RCA 1,22, IC: 1,05–1,42) et mentaux (RCA 2,32, IC: 2,01–2,68); à l’état de santé physique selon le questionnaire de santé SF-12 (RCA 0,98, IC: 0,96–0,99 pour chaque point d’augmentation) et à l’état de santé mentale selon le SF-1 2 (RCA 0,88, IC: 0,87–0,89).

CONCLUSIONS: La santé physique était indépendamment associée à l’idéation suicidaire après élimination des effets de l’état de santé mentale et des caractéristiques sociodémographiques. Ces constatations soulignent l’importance de tenir compte de la santé physique dans les efforts de prévention du suicide axés sur l’ensemble de la population et pour atténuer le risque de suicide chez les anciens combattants sur une base individuelle.

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Author information

Authors and Affiliations

  1. Veterans Affairs Canada, PO Box 7700, Rm. 406 DJM Bldg, 161 Grafton St., Charlottetown, PE, C1A 8M9, Canada

    James M. Thompson MD, CCFP(EM), FCFP (Research Directorate), Jill Sweet MSc, Linda VanTil DVM, MSc, Mary Beth MacLean MA & David Pedlar PhD

  2. Department of Public Health Sciences, Queen’s University, Kingston, ON, Canada

    James M. Thompson MD, CCFP(EM), FCFP (Research Directorate) & Wilma H. Hopman MA

  3. Directorate of Mental Health, Canadian Forces Health Services Group, Ottawa, ON, Canada

    Mark A. Zamorski MD, MHSA, CCFP

  4. Departments of Psychiatry, Psychology & Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada

    Jitender Sareen MD, FRCPC

  5. United States Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, USA

    Robert H. Pietrzak PhD, MPH

  6. Clinical Research Centre, Kingston General Hospital, Kingston, ON, Canada

    Wilma H. Hopman MA

  7. Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA

    Robert H. Pietrzak PhD, MPH

Authors
  1. James M. Thompson MD, CCFP(EM), FCFP
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  2. Mark A. Zamorski MD, MHSA, CCFP
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  3. Jill Sweet MSc
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  4. Linda VanTil DVM, MSc
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  5. Jitender Sareen MD, FRCPC
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  6. Robert H. Pietrzak PhD, MPH
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  7. Wilma H. Hopman MA
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  8. Mary Beth MacLean MA
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  9. David Pedlar PhD
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Corresponding author

Correspondence to James M. Thompson MD, CCFP(EM), FCFP.

Additional information

Source of Funding: Government of Canada.

Conflict of Interest: Drs. Thompson, Zamorski, VanTil and Pedlar and Ms. Sweet and Ms. MacLean are employees of the Government of Canada.

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Thompson, J.M., Zamorski, M.A., Sweet, J. et al. Roles of physical and mental health in suicidal ideation in Canadian Armed Forces Regular Force veterans. Can J Public Health 105, e109–e115 (2014). https://doi.org/10.17269/cjph.105.4217

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  • DOI: https://doi.org/10.17269/cjph.105.4217

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