To the Editor The study by Ms LeardMann and colleagues1 evaluated 83 suicides occurring among 151 560 military personnel over 707 493 person-years for predictors of suicide risk.
The Millennium Cohort Study (MCS), on which the analysis of LeardMann et al was based, is not a representative sample of recent US military personnel and has a significant sampling bias relative to risk factors for suicide. Phase 1 had a 36% response rate and its enrollees “were demographically older, more educated, married, and in the officer ranks, compared with individuals in the invited sample or the military population at large.”2 Of the approximately 350 000 personnel invited to enroll in phases 2 and 3, only 21% and 22% enrolled, respectively. Compared with invitees, enrollees in phases 2 and 3 had 77% to 91% higher odds of being female and 57% to 90% higher odds of being in noncombat military specialties.3
Nevin RL, Ritchie EC. Suicides Among Military Personnel. JAMA. 2013;310(23):2563-2564. doi:10.1001/jama.2013.282692