Depressed Vets Face Higher Suicide Risk

A study published in the January issue of the Journal of Affective Disorders suggests that vets with depression are at higher risk of commiting suicide during two critical periods: after discharge from a psychiatric hospital and after beginning treatment with an antidepressant.

Dr. Marcia Valenstein, a clinical psychiatrist at the VA Ann Arbor Healthcare System, and her team collected data from 887,859 VA hospital patients being treated for depression between April 1999 and September 2004. They then calculated the suicide rate for several 12-week periods, such as the start of treatment with antidepressants, after treatment changes and upon discharge from a psychiatric hospital.

The researchers found that the first 12 weeks after treatment with an antidepressant is initiated is a high risk period, with 210 suicides per 100,000 person-years, but the risk returns to normal after this period.

The researchers further found that patients were at a very high risk of suicide immediately following release from a psychiatric hospital. The suicide rate during this period was 568 per 100,000 person-years and did not return to normal until a year later.

The highest suicide risk was found among veterans aged 61 to 80.

There are currently no recommendations for closely monitoring recently discharged patients, although one widely used protocol does suggest one visit within the first seven days after discharge, said Valenstein.

Valenstein suggests that the greatest impact on suicide would be obtained by prioritizing suicide prevention efforts to the period following psychiatric hospitalization; and, if resources allow, closer monitoring should be provided to patients during their first 12 weeks of treatment with an antidepressant.