Vsevolod Rozanov; Vladimir Carli

“ Modern understanding of stress-vulnerability mechanisms based on genetic predispositions, early life development, level of exposure to stress and stress-reactivity together with interpersonal aspects may help to build more effective suicide prevention programs based on universal/selective/indicated prevention principles. ”

“ Studies among veterans from the Vietnam War have shown that there is a direct causal link between traumatic stress exposure and subsequent PTSD [ [26] . Moreover, those Vietnam veterans who had a diagnosis of PTSD were shown to have a significantly (~4-fold) increased standardised mortality rate of suicide [ [27] ; those who had been wounded were also at higher suicide risk [ [28] . In other studies, Vietnam veterans were shown to have increased levels of suicidal ideation and a history of suicide attempts ”

“ It should be noted that this contingent has many risk factors, such as stressful exposures, wounds, brain trauma and pain syndrome. Most recent observations confirm that veterans are really more likely to die of suicide as compared to the general population; they are also more likely to experience suicidal ideation and suffer from mental health problems. Suicides are more frequent in those who develop PTSD, depression and comorbid states due to war exposure. Combat stress and its’ frequency may be an important factor leading to suicide within the frame of the stress-vulnerability model. ”

“ This review attempts to understand why suicide is becoming more noticeable among war veterans. Returning back to the questions formulated in the beginning of this paper, we can conclude that war veterans definitely have specific social and environmental factors that may increase their risks for suicidality. ”

“ Modern challenges of growing war conflicts, and its potential for comorbid psychopathologies [4] , [5] , [6] , [57] , should be taken into consideration as a warning for exacerbating suicides, suicide attempts and psychopathology among newly released military personnel. This has been underscored in recent studies. Janet Wiener and colleagues have followed more than 10,000 veterans, who were hospitalized at the Veterans Affairs medical centre between 1993 and 1998 following a suicide attempt. ”

“ Is it due to the fact that in recent mission persons are faced with longer stays in the war zone, growing number of service tours (i.e., 6-month periods of war conditions) , increasing stressful exposures in war zones? Are we facing growing feelings of guilt, existential crises or other complex problems of transition to civilian life due to changing socio-economic situation? ”

“ Taking into account the “many faces” of male depression (aggression, alcohol abuse, poor social functioning) leading to male vulnerability and gender related public health paradoxes [ [56] , this idea looks very attractive. Logically the model of suicidal behavior in war veterans with PTMD has been proposed by L. Sher which consists of the following components: (1) genetic factors; (2) prenatal development; (3) biological and psychosocial influences from birth to mobilization/deployment; (4) mobilization/pre-deployment stress; (5) combat stress, traumatic brain injury, and physical injury ”

“ The author described studies suggesting that patients suffering from comorbid PTSD and MDD differ clinically and biologically from individuals with PTSD alone or MDD alone. Individuals with comorbid PTSD and MDD are characterized by a greater severity of symptoms, increased suicidality, and a higher level of impairment in social and occupational functioning [ [55] . ”

“ A combination of state-of-the-art research concerning developmental trajectory and stress-vulnerability acquirement via genetic and epigenetic mechanisms are also needed.
References ↑ Mahon, M.J.; Tobin, J.P.; Cusack, D.A.; Kelleher, C. & Malone, K.M. (2005) , Suicide among regular-duty military personnel: A retrospective case-control study of occupation-specific risk factors for workplace suicide, vol. 162, pp. 1688–1696, 16135629, pmid:16135629 ↑ Zamorski, M.A. (2011) , Suicide prevention in military organizations, vol. ”

“ Self-inflicted deaths among women with US military service: A hidden epidemic?, vol. 61 ↑ Ku, Y.C.; Tsai, Y.F.; Lin, Y.C. & Lin, I.P. (2009) , Suicide experiences among institutionalized older veterans in Taiwan, vol. 49, pp. 746–754, 19597056, pmid:19597056 1 2 Thoresen, S.; Mehlum, L. & Moller, B. (2003) , Suicide in peacekeepers—A cohort study of mortality from suicide in 22,275 Norwegian veterans from international peacekeepers operations, vol. ”