title: Prevalence and correlates of suicidal ideation and suicide attempts among veterans in primary care referred for a mental health evaluation.
abstract: BACKGROUND
  The Veterans Health Administration has made concerted efforts to increase mental health services offered in primary care. However, few studies have evaluated correlates of suicidal ideation and suicide attempt in veterans in primary care-mental health integration (PCMHI). The purpose of the present study is to examine associations between suicidal ideation and suicide attempts as dependent variables and demographic and clinical factors as the independent variables.
  
  
  METHODS
  Veterans (n=3004) referred from primary care to PCMHI were contacted for further assessment, which included past-year severity of suicidal thoughts (none, low, high) and attempts using the Paykel Suicide Scale, mental health disorders, and illicit drug use. Multinomial logistic regression models were used to identify correlates of suicidal ideation and suicide attempts.
  
  
  RESULTS
  Thoughts of taking one's life was endorsed by 24% of participants and suicide attempts were reported in 2%. In adjusted models, depression, psychosis, mania, PTSD and generalized anxiety disorder were associated with high severity suicidal ideation, but not suicide attempt. Illicit drug use was not associated with suicidal ideation, but was the only variable associated with suicide attempt.
  
  
  CONCLUSIONS
  The study was cross-sectional, focused on one clinical setting, and the suicide attempt analyses had limited power.
  
  
  CONCLUSIONS
  PCMHI is a critical setting to assess suicidal ideation and suicide attempt and researchers and clinicians should be aware that the differential correlates of these suicide-related factors. Future research is needed to identify prospective risk factors and assess the utility of follow-up care in preventing suicide.
authors.affiliation: VISN 2 Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, USA; Department of Psychiatry, University of Rochester, School of Medicine & Dentistry, USA. Electronic address: Lisham.Ashrafioun@va.gov.
authors.forename: Lisham
authors.initials: L
authors.lastname: Ashrafioun
authors.affiliation: VISN 2 Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, USA; Department of Psychiatry, University of Rochester, School of Medicine & Dentistry, USA.
authors.forename: Wilfred R
authors.initials: WR
authors.lastname: Pigeon
authors.affiliation: VISN 2 Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, USA; Department of Psychiatry, University of Rochester, School of Medicine & Dentistry, USA.
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: Conner
authors.affiliation: Department of Psychiatry, University of Pennsylvania, USA; VISN 4 Mental Illness, Research, Education and Clinical Center, Philadelphia VA Medical Center, USA.
authors.forename: Shirley H
authors.initials: SH
authors.lastname: Leong
authors.affiliation: Department of Psychiatry, University of Pennsylvania, USA; VISN 4 Mental Illness, Research, Education and Clinical Center, Philadelphia VA Medical Center, USA.
authors.forename: David W
authors.initials: DW
authors.lastname: Oslin
mesh_terms: D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology*; D003866:Depressive Disorder / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D008605:Mental Health Services; D008875:Middle Aged; D011446:Prospective Studies; D011618:Psychotic Disorders / Q000523:psychology*; D012307:Risk Factors; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data*; D014728:Veterans / Q000523:psychology*
keywords: Primary care; Suicidal ideation; Suicide attempt; Veterans