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Risk factors for suicide in the Israeli army between the years 1992–2012: A case-control study*

Published online by Cambridge University Press:  23 March 2020

L. Shelef
Affiliation:
Psychology Branch, Israeli Air Force, Ramat Gan, Israel Mental Health Department, Medical Corps, Israel Defense Forces, Ramat Gan, Israel
G. Tomer*
Affiliation:
Military Track, The Hebrew University – Hadassah Medical School, Jerusalem, Israel
L. Tatsa-Laur
Affiliation:
Mental Health Department, Medical Corps, Israel Defense Forces, Ramat Gan, Israel
R. Kedem
Affiliation:
Mental Health Department, Medical Corps, Israel Defense Forces, Ramat Gan, Israel
O. Bonne
Affiliation:
Chair, Department of Psychiatry, The Hebrew University – Hadassah Medical School, Hadassah University Hospital, Jerusalem, Israel
E. Fruchter
Affiliation:
Mental Health Department, Medical Corps, Israel Defense Forces, Ramat Gan, Israel
*
Corresponding author at: Medical Corps, Israel Defense Force, The Hebrew University – Hadassah Medical School, Guatemala 9/22, Jerusalem 9670405, Israel. Tel.: +972 5 44220880; fax: +972 4 6289299. E-mail address:gaiatomer@gmail.com (G. Tomer).
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Abstract

Objective

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.

Methods

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.

Results

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.

Conclusions

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.

Type
Original article
Copyright
Copyright © Elsevier Masson SAS 2017

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Footnotes

This study was carried out as part of the M.D. thesis required by the Hebrew University – Hadassah Medical School.

1

Leah Shelef and Gaia Tomer share first authorship of this article.

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