Early deployment tied to increased suicide risk for soldiers

(Reuters Health) - When soldiers have their first deployment within their first year of service, they may be twice as likely to attempt suicide during or after their second deployment, a U.S. study suggests.

Researchers focused on 593 U.S. Army soldiers who had experienced two deployments within two years of continuous military service and had attempted suicide.

While a quick deployment was linked to a larger increase in the risk of attempted suicide, the study also found that a gap of six months or less between deployments was associated with a 60 percent higher risk.

“Deploying earlier in one’s career may result in additional strain on the brain and body given that they have not gone through as much training and preparation for combat,” said study co-author Dr. Gary Wynn, a lieutenant colonel in the U.S. Army and a psychiatry researcher at the Uniformed Services University of the Health Sciences in Bethesda, Maryland.

“The brain’s ability to deal with adversity and to process potentially traumatic experiences may not be as well-developed, resulting in additional overall strain on the individual compared to someone more trained and more secure in their place within the military,” Wynn said by email. “This additional stress, both mental and physical, may lead to a variety of mental health problems including suicidal behaviors.”

Suicide attempts and deaths have become more common in the U.S. Army since the start of the wars in Iraq and Afghanistan, researchers note in JAMA Psychiatry. Readiness for deployment - both physical and mental - has been seen as one of many potential factors influencing soldiers’ suicide risk.

In the current study, most of the soldiers were male and white, with at least a high school education when they joined the military. Most of them were also under 21 years old at enlistment and married.

Overall, the researchers calculated that early deployment contributed 14 percent of a soldier’s suicide risk and having less than six months between deployments accounted for 4 percent of the risk.

Indeed, most of the attempted suicide cases, 72 percent, occurred among soldiers who had been in the service for at least 13 months before their first deployment, the researchers note.

And slightly more than half of the cases happened among soldiers whose first deployments lasted at least nine months.

The duration of soldiers’ first deployment, however, didn’t appear to influence their risk of attempted suicide.

One limitation of the study is that researchers relied on administrative data on suicide attempts and mental health care, and it’s possible some cases might be missing from these records, the study authors note.

Results from the analysis of suicide attempts between 2004 and 2009 also may not reflect the experiences of soldiers who deployed at other times. The study also doesn’t look at suicide deaths.

“Whether or not there is a history of deployment, the strongest link to suicidal behavior has consistently been the presence of one or more underlying mental disorders,” said Dr. Charles Hoge, a staff psychiatrist at Walter Reed National Military Medical Center in Bethesda, Maryland, who wasn’t involved in the study.

Still, the results might serve as a guide in the military for planning deployment rotation cycles to support soldiers’ mental health, Hoge said by email.

The findings also highlight a need to help soldiers maintain healthy relationships with friends and family so they have a support system to help them cope with their experiences in the military, said Alan Peterson of the University of Texas Health Science Center at San Antonio.

This is particularly true for younger soldiers whose brains are still developing, Peterson, who wasn’t involved in the study, said by email.

“Most neuroscientists believe that human brain continues to mature and develop until age 25 to 30,” Peterson said. “Brain changes may occur in soldiers who deploy within the first 12 months of entry onto active duty that reduce their capacity to cope across the deployment cycle.”

SOURCE: JAMA Psychiatry, online April 18, 2018.