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Comparative Study
. 2011 Dec;72(12):1585-90.
doi: 10.4088/JCP.11m06879. Epub 2011 Aug 23.

Suicide deaths of active-duty US military and omega-3 fatty-acid status: a case-control comparison

Michael D Lewis  1 , Joseph R Hibbeln, Jeremiah E Johnson, Yu Hong Lin, Duk Y Hyun, James D Loewke
Affiliations
Comparative Study

Suicide deaths of active-duty US military and omega-3 fatty-acid status: a case-control comparison

Michael D Lewis et al. J Clin Psychiatry. 2011 Dec.

Abstract

Background: The recent escalation of US military suicide deaths to record numbers has been a sentinel for impaired force efficacy and has accelerated the search for reversible risk factors.

Objective: To determine whether deficiencies of neuroactive, highly unsaturated omega-3 essential fatty acids (n-3 HUFAs), in particular docosahexaenoic acid (DHA), are associated with increased risk of suicide death among a large random sample of active-duty US military.

Method: In this retrospective case-control study, serum fatty acids were quantified as a percentage of total fatty acids among US military suicide deaths (n = 800) and controls (n = 800) matched for age, date of collection of sera, sex, rank, and year of incident. Participants were active-duty US military personnel (2002-2008). For cases, age at death ranged from 17-59 years (mean = 27.3 years, SD = 7.3 years). Outcome measures included death by suicide, postdeployment health assessment questionnaire (Department of Defense Form 2796), and ICD-9 mental health diagnosis data.

Results: Risk of suicide death was 14% higher per SD of lower DHA percentage (OR = 1.14; 95% CI, 1.02-1.27; P < .03) in adjusted logistic regressions. Among men, risk of suicide death was 62% greater with low serum DHA status (adjusted OR = 1.62; 95% CI, 1.12-2.34; P < .01, comparing DHA below 1.75% [n = 1,389] to DHA of 1.75% and above [n = 141]). Risk of suicide death was 52% greater in those who reported having seen wounded, dead, or killed coalition personnel (OR = 1.52; 95% CI, 1.11-2.09; P < .01).

Conclusion: This US military population had a very low and narrow range of n-3 HUFA status. Although these data suggest that low serum DHA may be a risk factor for suicide, well-designed intervention trials are needed to evaluate causality.

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Conflict of interest statement

The authors have no potential conflicts of interest, financial or otherwise.

Figures

Figure 1
Figure 1. Odds Ratios of Male Suicide Death andOctilesof DHA Status
Odds ratios and 95% CIs for suicide death are indicted by solid bars and lines respectively. REF indicates reference group, the highest octile of DHA %. Means and ranges of DHA% are indicated for each octile. A statistically significant protective effect was only observed in the highest octile compared to each of the lowest six octiles.
See this image and copyright information in PMC

Comment in

References

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