Leo Sher, M.D.

Our case report, “Another casualty of war: Using the stress-diathesis model to conceptualize a combat veteran suicide death” has been published in Psychiatria Danubina (1). A summary of our work is provided below.

Suicide remains a significant public health concern among U.S. military veterans, with rising rates linked to the complex psychological, medical, and psychosocial burdens associated with combat service. This case report describes a 47-year-old combat veteran with PTSD, major depressive disorder, alcohol use disorder, diabetes, and numerous life stressors who ultimately died by suicide. His combat experiences included firefights, ambushes, exposure to death, and chronic fear, which contributed to persistent symptoms such as hypervigilance, nightmares, irritability, and suicidal thoughts. After discharge from the military, he struggled with employment, financial hardship, divorce, homelessness, and difficulties managing his medical needs, further worsening his mental health. Although he received inpatient psychiatric treatment, medications, and outpatient follow-up after expressing suicidal intent, he died by suicide shortly after discharge. The authors interpret the case using the stress-diathesis model, identifying predisposing vulnerabilities (childhood adversity, trauma, psychiatric disorders, diabetes) interacting with acute stressors (depression, divorce, unemployment, homelessness) to precipitate suicide. They conclude that preventing veteran suicide requires comprehensive, closely monitored psychiatric, medical, and psychosocial care, particularly during high-risk periods such as post-hospital discharge.

Reference

1. Levine J, Sher L. Another casualty of war: Using the stress-diathesis model to conceptualize a combat veteran suicide death. Psychiatr Danub. 2025 Sep;37(3):374-376. doi: 10.24869/psyd.2025.374.