2053. More Risk for Suicide in Veterans with Schizophrenia and PTSD
Jennifer L Strauss, PhD, Durham VAMC, HSR in Primary Care and Duke University Medical Center, PS Calhoun, Durham VAMC, HSR in Primary Care and Duke University Medical Center, CE Marx,
Durham VAMC, Department of Psychiatry and Duke University Medical Center, MI Butterfield,
Durham VAMC, HSR in Primary Care and Duke University Medical Center
Objectives: About 30-40% of persons with schizophrenia have comorbid posttraumatic stress disorder (PTSD). These individuals report lower quality of life, poorer health, high use of health services, and may be at high risk for suicidality.
Methods: Male veterans with schizophrenia spectrum disorders were recruited from the Durham VAMC psychiatric inpatient unit between 1998-2000 (N = 165). Comorbid PTSD was assessed with the PTSD Checklist (PCL). Six-month history of suicidality (ideation, attempt or deliberate self-harm) was assessed with the Duke Mental Health Study Inventory. Psychoticism and substance use were assessed with the Brief Psychiatric Rating Scale (BPRS) and Dartmouth Assessment of Lifestyle Instrument (DALI), respectively.
Results: Seventy-eight patients (47.3%) met DSM-IV criteria for comorbid PTSD. Those with PTSD did not differ in age, race, education, marital status, psychoticism, alcohol or drug use compared to those without PTSD. In comparative analyses, those with comorbid PTSD were more likely to report suicidal ideation (n = 53 versus n = 29; Chi-square = 19.71, p < .0001), and the association of suicidal behaviors with PTSD approached significance (n = 11 versus n = 5; Chi-square = 3.28, p = .07). PTSD remained significantly associated with increased suicidal ideation in an adjusted model that accounted for age, marital status and substance use.
Conclusions: Hospitalized veterans with schizophrenia and PTSD are at higher risk for suicidality than those without PTSD.
Impact: Veterans with schizophrenia should be carefully screened for PTSD and suicidality. Targeted interventions addressing suicide risk in this cohort may be warranted.