Internet and Psychiatry
  • Home
    • Editorials
    • Research news
    • Research papers
    • Interviews with eminent psychiatrists
    • Ten years ago
    • Fifteen years ago
  • Topics
    • Alcohol and Drug Abuse
    • Anxiety Disorders
    • Biomedical Science
    • Compulsive gambling
    • Disaster Medicine
    • Education
    • General Medicine
      • Acupuncture
      • Physical medicine and Rehabilitation
    • Human Rights
    • Interviews with eminent psychiatrists
    • Mood Disorders
      • Bipolar Disorder
      • Depression
      • Seasonal Affective Disorder
    • Neurological Disorders
    • Other Psychiatric Disorders
    • Posttraumatic Stress Disorder
    • Sexual Behavior
  • Books
    • Comorbidity of Depression and Alcohol Use Disorders
    • “Immigration and Mental Health” chapter abstracts
    • “Internet and Suicide” chapter abstracts
    • “Neurobiology of PTSD” chapter abstracts
    • “Suicidal Behavior in Alcohol…” chapter abstracts
    • “Suicide in the Military” chapter abstracts
    • “Terror and Suicide” chapter abstracts
    • “War and Suicide” chapter abstracts
  • Editors
    • Leo Sher, M.D.
    • Alexander Vilens, M.S.
  • Guests
    • Distinguished Guests
    • Our Contributors
  • Reflections
    • Poetry
    • Quotes

Posttraumatic Stress Disorder

A model of suicidal behavior in war veterans with posttraumatic mood disorder

July 8, 2010

Sher L.
Department of Psychiatry, Columbia University, New York State Psychiatric Institute, 1051 Riverside Drive, Suite 2917, Box 42, New York, NY 10032, USA.
Med Hypotheses. 2009 Aug;73(2):215-9.

Many wars have been fought during the history of civilization. About 30 armed conflicts are occurring now around the globe involving more than 25 countries. Many war veterans have symptoms of posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) including suicidal ideation and behavior. PTSD is frequently comorbid with MDD. I have previously proposed that some or all individuals diagnosed with comorbid PTSD and MDD have a separate psychobiological condition that can be termed “posttraumatic mood disorder” (PTMD).

This idea was based on the fact that a significant number of studies suggested that patients suffering from comorbid PTSD and MDD differed clinically and biologically from individuals with PTSD alone or MDD alone. Individuals with comorbid PTSD and MDD are characterized by greater severity of symptoms, increased suicidality and the higher level of impairment in social and occupational functioning compared to individuals with PTSD alone or MDD alone. Neurobiological evidence supporting the concept of PTMD includes the findings from neuroendocrine challenge, cerebrospinal fluid, neuroimaging, sleep and other studies. In this paper, I propose a model of suicidal behavior in war veterans with PTMD. The model consists of the following components: (1) genetic factors; (2) prenatal development; (3) biological and psychosocial influences from birth to mobilization/deployment; (4) mobilization/pre-deployment stress; (5) combat stress, traumatic brain injury, and physical injury; (6) post-deployment stress; (7) biological and psychosocial influences after the deployment; (8) trigger (precipitant) of a suicidal act; and (9) suicidal act. The first four components determine vulnerability to combat stress. The first seven components determine predisposition to suicidal behavior, a key element that differentiates PTMD patients who are at high risk from those at lower risk. Suicidal behavior in PTMD can be attributed to the coincidence of a trigger with a predisposition for suicidal behavior. Suicide prevention in war veterans with PTMD should focus on (1) improvement in recognition of PTMD; (2) treating symptoms of PTMD; (3) preventing a relapse when the patient is in remission; (4) treating suicidal ideation; (5) treating comorbid psychiatric conditions including alcohol and drug abuse; (6) treating medical and neurological disorders including traumatic brain injury; and (7) social support. It is extremely important to understand PTMD, to optimize assessment and treatment for people with PTMD, and to identify processes that facilitate recovery from exposure to traumatic events. Every nation, every generation, faces traumas that cause suicide. The world needs to deal with this and it is one thing that the world can come together on.

Related Posts

Posttraumatic Stress Disorder /

Translational evidence for a role of endocannabinoids in the etiology and treatment of posttraumatic stress disorder

Posttraumatic Stress Disorder /

Family support, family stress and suicidal ideation in a combat-exposed sample of OEF/OIF Veterans

Posttraumatic Stress Disorder /

Cortisol response to cosyntropin administration in military veterans with or without posttraumatic stress disorder

‹ Dominance, politics, and physiology: voters’ testosterone changes on the night of the 2008 United States presidential election › Partial Agonist Therapy in Schizophrenia: Relevance to Diminished Criminal Responsibility

Editorials

  • Suicide medical malpractice
  • Dr. Slavko Ziherl, an eminent Slovenian psychiatrist
  • Prevention of suicidal behavior in individuals with diabetes
  • National Respect Day

Research Papers

  • COVID-19 mortality in Europe and the ’Iron Curtain’ between East and West
  • Examination of depressive signs and symptoms among 803 University students in seven Universities and Colleges. Hungary, Romania, Serbia.
  • Examination of spirituality and the dimensions of spirituality among 803 students in seven different Universities. Hungary, Romania and Serbia.
  • Examination of depressive signs and symptoms among 932 students in eight different secondary schools in Hungary

Research News

  • Mortality in patients with schizophrenia: a review and meta-analysis
  • Long COVID, psychiatric disorders and suicidality
  • Mortality rates for buprenorphine versus methadone treatments
  • Brain-derived neurotrophic factor levels in combat veterans with or without a history of suicide attempt

Latest News

  • Best universities in the world
  • Geriatric Psychiatry Fellowship
  • 2022 National Veteran Suicide Prevention Annual Report
  • Long COVID and suicide

Interviews with eminent psychiatrists

  • Interview with Professor Shih-Ku Lin
  • Interview with Professor Masahito Fushimi
  • Interview with Professor Maurizio Pompili
  • Interview with Professor Marco Sarchiapone

Ten Years Ago

  • Plasma testosterone levels in bipolar suicide attempters
  • Teaching medical professionals and trainees about suicide prevention
  • Suicidal ideation in depressed patients with or without comorbid posttraumatic stress disorder treated with selective serotonin reuptake inhibitors
  • Treatment of suicide attempters with bipolar disorder: a randomized clinical trial

Back to Top

  • About
  • Contact
  • Privacy Policy
  • Terms and Conditions
Copyright © 2022 AVCalc LLC. All rights reserved worldwide.