Former military personnel are twice as likely to kill themselves as people who have not seen combat reports a study in the July issue of Journal of Epidemiology and Community Health.

The results suggest that doctors need to look out for signs of suicidal intentions in soldiers returning from service in Afghanistan and Iraq.

Researchers in the United States followed up 320,000 men aged over 18 years for 12 years and found that those who had served in the armed forces at some time between 1917 and 1994 were twice as likely to die from suicide compared with men in the general population.

The risk was highest in veterans who could not participate fully in home, work or leisure activities because of a health problem. Veterans that killed themselves were also more likely to be older, white, better educated and less likely to have never been married than other suicides.

Interestingly, former soldiers who were overweight were far less likely to kill themselves than those of normal weight.

However, a tour of duty in the military did not increase the risk of dying from natural or accidental causes, or of being a homicide victim.

The authors concluded: 'With the projected rise in functional impairments and psychiatric morbidity among veterans of the conflicts in Afghanistan and Iraq, clinical and community interventions that are directed towards these patients are needed.'

'Clinicians need to be alert for signs of suicidal intent among veterans, as well as their access to firearms.'

The researchers found that veterans were 58% more likely to use a gun to kill themselves than other suicides.

The research was funded with a grant from the US National Institute of Mental Health.