Question

Question: Is there an association between military service in Iraq and Afghanistan, psychiatric comorbidity and suicide mortality?

People: All 5 772 282 veterans who had used the Veterans Health Administration (VHA) services during fiscal year (FY) 2007 or 2008. Veterans were 90.5% male and an average age of 60.9 years. Among these veterans, 309 108 were Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) veterans who had served in the conflicts of Iraq and Afghanistan and the remaining 5 463 174 were non-OEF/OIF veterans who had served in other conflicts.

Setting: VHA, USA; 2007–2008.

Risk factors: OEF/OIF status and psychiatric comorbidity. The VHA's National Patient Care Database (NPCD) was used to identify any use of inpatient, residential or outpatient services during FY07 or FY08. Diagnoses of depression, schizophrenia, bipolar disorder, substance use disorder, post-traumatic stress disorder (PTSD) and other anxiety disorders were coded according to ICD-9. VHA users were categorised as OEF/OIF if the date of last deployment in the VHA's OEF/OIF roster was on or before the end of FY08. Analyses were controlled for …