title: Suicidal ideation in veterans misusing alcohol: relationships with insomnia symptoms and sleep duration.
abstract: OBJECTIVE
  The aim of this investigation was to assess the relationships between suicidal ideation and insomnia symptoms in Veterans misusing alcohol.
  
  
  METHODS
  Data were extracted in this retrospective chart review of Veterans referred from primary care for a behavioral health evaluation (N=161) based on evidence of heavy drinking, drug use or another behavioral problem. Suicidal ideation (SI) was assessed using the Paykel questionnaire. Insomnia symptoms were assessed with standard diary questions in an interview format and pertained to sleep latency (SL), wake after sleep onset time (WASO), sleep quality (SQ), and habitual sleep duration (HSD). The relations between suicidal ideation and insomnia symptoms were assessed using ordinal regression analyses adjusted for socio-demographic, psychiatric and addiction-related variables.
  
  
  RESULTS
  Suicidal ideation was reported in 62 (39%) of the Veterans interviewed. In a multivariable model, only inadequate SQ was associated with suicidal ideation. Short sleepers were more likely to endorse suicidal ideation and have attempted suicide in the past year. In addition, older age, inadequate financial status, and the presence of a psychiatric disorder were also significantly associated with suicidal ideation in most of the adjusted models.
  
  
  CONCLUSIONS
  Given their association with suicidal ideation, insomnia symptoms in Veterans misusing alcohol should prompt an assessment of underlying psychiatric and social factors.
authors.affiliation: MIRECC VISN-4, Philadelphia Veterans Affairs Medical Center, United States; Perelman School of Medicine, University Of Pennsylvania, United States. Electronic address: Subhajit.Chakravorty@uphs.upenn.edu.
authors.forename: Subhajit
authors.initials: S
authors.lastname: Chakravorty
authors.forename: Michael A
authors.initials: MA
authors.lastname: Grandner
authors.forename: Shahrzad
authors.initials: S
authors.lastname: Mavandadi
authors.forename: Michael L
authors.initials: ML
authors.lastname: Perlis
authors.forename: Elliott B
authors.initials: EB
authors.lastname: Sturgis
authors.forename: David W
authors.initials: DW
authors.lastname: Oslin
mesh_terms: D019973:Alcohol-Related Disorders / Q000453:epidemiology* / Q000523:psychology; D063425:Binge Drinking / Q000453:epidemiology / Q000523:psychology; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D008875:Middle Aged; D015143:Philadelphia / Q000453:epidemiology; D011320:Primary Health Care / Q000379:methods; D012017:Referral and Consultation; D012044:Regression Analysis; D012189:Retrospective Studies; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology* / Q000523:psychology; D012907:Smoking / Q000453:epidemiology / Q000523:psychology; D012959:Socioeconomic Factors; D059020:Suicidal Ideation; D011795:Surveys and Questionnaires; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data
keywords: Alcohol; Insomnia; Sleep duration; Suicidal ideation; Veterans