The following is a summary of “Longitudinal Trends in Suicidal Thoughts and Behaviors Among US Military Veterans During the COVID-19 Pandemic,” published in the April 2023 issue of Psychiatry by Fischer, et al.
Since the start of the COVID-19 pandemic, concerns have been raised about the potential increase in suicidal thoughts and behaviors (STBs) among vulnerable populations, including military veterans. For a study, researchers sought to examine the longitudinal trends in STBs among US military veterans during the first three years of the COVID-19 pandemic.
The study design involved a population-based longitudinal approach using three National Health and Resilience in Veterans Study surveys. The data collection occurred on the following median dates: November 21, 2019 (pre-pandemic), November 14, 2020, and August 18, 2022.
The results of the longitudinal study, which included 2,441 veterans (mean age 63.2 years [SD 14.0]; 92.1% male), showed that past-year suicidal ideation decreased from 9.3% before the pandemic (95% CI, 8.2%-10.6%) to 6.8% one year later (95% CI, 5.8%-7.9%), and then slightly increased to 7.7% two years later (95% CI, 6.7%-8.9%). During the follow-up period, 9 veterans (0.4%) reported at least one suicide attempt, while 100 (3.8%) developed new-onset suicidal ideation and 28 (1.2%) developed new-onset suicide planning. After adjusting for sociodemographic and military characteristics, certain factors were strongly associated with new-onset suicidal ideation, including higher education (odds ratio [OR] 3.27; 95% CI, 1.95-5.46), lifetime substance use disorder (OR 2.07; 95% CI, 1.23-3.46), pre pandemic loneliness (OR 1.28; 95% CI, 1.09-1.49), and lower pre pandemic purpose in life (OR 0.92; 95% CI, 0.86-0.97). Factors associated with new-onset suicide planning included lifetime substance use disorder (OR 3.03; 95% CI, 1.22-7.55), higher pre-pandemic psychiatric distress (OR 1.52; 95% CI, 1.06-2.18), and lower pre pandemic purpose in life (OR 0.88; 95% CI, 0.81-0.95).
In conclusion, contrary to expectations, the prevalence of STBs did not increase for most US veterans during the COVID-19 pandemic. However, veterans with preexisting loneliness, psychiatric distress, and lower purpose in life had a heightened risk of developing new-onset suicidal ideation and suicide planning during the pandemic. To mitigate suicide risk in the population, evidence-based prevention and intervention efforts targeting these factors should be implemented.