title: Risk factors for suicide in the Israeli army between the years 1992-2012: A case-control study.
abstract: Young age, availability of weapons, and stressful life events, increase the risk of suicide. The aim of the present study was to assess additional risk factors for suicide in the Israeli army.
  
  
  
  We conducted a case-control study, to assess risk factors for suicide. The cases comprised soldiers who died by suicide during their military service (n=462; 0.039% of all soldiers in the cohort). The control group consisted of soldiers who did not commit suicide but were in active service during the investigated period (n=1,170,895; 99.96%). Predictor variables, including socio-demographic and psychiatric diagnoses, were considered.
  
  
  
  Using a Generalized Linear Model with a Binary Logistic dependent variable to predict suicide, while controlling the effect of intervening variables, we found the following variables enhanced the risk for committing suicide: male (RR=6.703; P<0.001), country of origin: Ethiopia (RR=4.555; P=0.014), low socioeconomic status (RR=1.448; P=0.016) and low adjustment difficulties (RR=2.324; P<0.001). In addition, we found that in males only, Cluster B Personality Disorder (RR=2.548; P=0.027), low (RR=1.657; P=0.002), to average motivation to serve in a combat unit (RR=1.322; P=0.046) increased the risk for suicide.
  
  
  
  IDF Soldiers bearing a psychiatric diagnosis or severe adjustment difficulties remained tightly monitored through their military service, and were found to be at a lower risk for suicide. However, those enlisted with mild (low) difficulties, were found to be at greater risk for suicide, as well as soldiers whose country of origin is Ethiopia. Suicide prevention program should focus on monitoring soldiers with these risk factors, together with soldiers' guidance regarding help seeking and de-stigmatizing suicide.
authors.affiliation: Psychology Branch, Israeli Air Force, Ramat Gan, Israel; Mental Health Department, Medical Corps, Israel Defense Forces, Ramat Gan, Israel.
authors.forename: L
authors.initials: L
authors.lastname: Shelef
authors.affiliation: Military Track, The Hebrew University - Hadassah Medical School, Jerusalem, Israel. Electronic address: gaiatomer@gmail.com.
authors.forename: G
authors.initials: G
authors.lastname: Tomer
authors.affiliation: Mental Health Department, Medical Corps, Israel Defense Forces, Ramat Gan, Israel.
authors.forename: L
authors.initials: L
authors.lastname: Tatsa-Laur
authors.affiliation: Mental Health Department, Medical Corps, Israel Defense Forces, Ramat Gan, Israel.
authors.forename: R
authors.initials: R
authors.lastname: Kedem
authors.affiliation: Chair, Department of Psychiatry, The Hebrew University - Hadassah Medical School, Hadassah University Hospital, Jerusalem, Israel.
authors.forename: O
authors.initials: O
authors.lastname: Bonne
authors.affiliation: Mental Health Department, Medical Corps, Israel Defense Forces, Ramat Gan, Israel.
authors.forename: E
authors.initials: E
authors.lastname: Fruchter
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007557:Israel; D008297:Male; D008889:Military Personnel / Q000523:psychology* / Q000706:statistics & numerical data*; D009042:Motivation; D010554:Personality Disorders / Q000453:epidemiology* / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Adolescents; Israeli Defense Forces; Military; Suicide