Suicide Attempts in the US Army

To the Editor The article by Ursano et al¹ contributes much to the important dialogue on suicide in active-duty soldiers, but one of the central points requires clarification and further exploration. The authors examined diagnostic codes in the electronic medical record system and another clinician-populated surveillance database called the Department of Defense Suicide Event Report (DODSER) to conclude that the risk for suicide attempts is lower in soldiers who are currently deployed compared with soldiers who have either never been or were previously deployed. The authors discussed the potential implications of this finding but did not acknowledge the principal methodological limitation of the data on which they based their findings.