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Posttraumatic Stress Disorder and Suicide Risk Among Veterans: A Literature Review

Pompili, Maurizio MD, PhD*; Sher, Leo MD†‡; Serafini, Gianluca MD, PhD*; Forte, Alberto MSc*; Innamorati, Marco PsyD*; Dominici, Giovanni MSc*; Lester, David PhD§; Amore, Mario MD; Girardi, Paolo MD*

The Journal of Nervous and Mental Disease: September 2013 - Volume 201 - Issue 9 - p 802–812
doi: 10.1097/NMD.0b013e3182a21458
Review Article

Posttraumatic stress disorder (PTSD) is frequently associated with suicidal ideation and suicide attempts. Suicide is an important cause of death in veterans, and the risk for intentional death continues to be high many years after service. The aim of the present study was to investigate whether there is a relationship between PTSD and suicidal behavior among veterans. We also discussed the risk factors of suicide among war veterans with PTSD. A systematic review was conducted focusing on war-related PTSD and suicidal behavior. A total of 80 articles from peer-reviewed journals were identified, 34 were assessed for eligibility, and 16 were included. Having a history of PTSD is associated with higher rates of morbidity and mortality and increased the risk for suicidal behavior. The association between PTSD and suicidal behavior was confirmed by the presence of other risk factors and high rates of comorbidity. Current suicidal behavior should be adequately assessed in war veterans.

*Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, Rome, Italy; †James J. Peters Veterans Administration Medical Center, New York, NY, USA; ‡Mount Sinai School of Medicine, New York, NY; §The Richard Stockton College of New Jersey, Galloway, NJ; and ∥Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genova, Genova, Italy.

Send reprint requests to Maurizio Pompili, MD, PhD, Department of Psychiatry, Sant’Andrea Hospital, Sapienza University of Rome, 1035 Via di Grottarossa, 00189 Rome, Italy. E-mail:

© 2013 by Lippincott Williams & Wilkins