Suicide Risk Among Veterans Who Receive Evidence-Based Therapy for Posttraumatic Stress Disorder

Area of Science:

• Mental Health
• Public Health
• Veterans Affairs

Background:

• Veterans with posttraumatic stress disorder (PTSD) have elevated suicide rates.
• Understanding treatment impacts on suicide risk is crucial for Veterans Health Administration (VHA) operations.

Purpose of the Study:

• To assess suicide risk among veterans diagnosed with PTSD who initiated or completed evidence-based psychotherapy (cognitive processing therapy or prolonged exposure [CPT/PE]).

Main Methods:

• A cohort study analyzed suicide risk through 2020 for US veterans diagnosed with PTSD between 2016-2019.
• Data included VHA care records and death certificate information.
• Multivariable proportional hazards regression modeled suicide risk based on CPT/PE initiation and completion.

Main Results:

• Initiating CPT/PE was associated with a 23% reduction in suicide risk compared to non-initiation.
• Receipt of an adequate course (≥8 CPT/PE sessions) was not significantly associated with lower suicide risk.
• These findings held true even when analyzing veterans who received any psychotherapy.

Conclusions:

• Initiating CPT/PE treatment is linked to decreased suicide risk for veterans with new PTSD diagnoses within the VHA system.
• While initiation is beneficial, the number of sessions (≥8) did not provide additional suicide risk reduction.
• Further research may explore optimal treatment durations and modalities for suicide prevention in this population.