***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background .There have been major reductions in the availability of inpatient psychiatric care in the United States in recent years . Objective .The objective of this study was to evaluate the clinical impact of cost-cutting changes in the delivery of inpatient psychiatric care . Design .This was a nonequivalent control group pre/post design . Subjects . Outcome data on 6,397 veterans treated between 1993 and 2000 at 35 specialized VA inpatient and residential programs for posttraumatic stress disorder ( PTSD ) were used to compare changes in effectiveness ( measured as patient improvement from admission to 4 months after discharge ) at programs that either shortened their average length of stay or converted from a hospital-based program to a low-cost residential rehabilitation program . For comparison , outcome data are also presented over the same years from both inpatient PTSD programs and residential PTSD programs that did not experience program change . Measures . Measures addressed baseline characteristics and 4-month postdischarge outcome measures of PTSD symptoms , substance abuse , violent behavior , and employment . Results .Analyses of covariance showed no significant change in outcomes at inpatient programs that either reduced their length of stay or did not change at all . However , effectiveness declined on some measures at inpatient programs that converted to residential treatment during this period but improved at residential treatment programs that had been established before this period of change . Conclusions .Although there was no deterioration in effectiveness related to reduced length of inpatient stay , programs that converted to a residential model showed decreased effectiveness OBJECTIVE To study the relation between posttraumatic stress disorder ( PTSD ) psychiatric comorbidity and suicidal ideation in a representative sample of Ohio Army National Guard soldiers . METHOD Using retrospective data collected on the telephone from a r and om sample of 2,616 National Guard soldiers who enrolled in a 10-year longitudinal study ( baseline data collected November 2008-November 2009 ) , we examined ( 1 ) the prevalence of other psychopathologies among those with DSM-IV-diagnosed PTSD compared to those without PTSD and ( 2 ) the association between PTSD comorbidity and suicidal ideation ( reporting thoughts of being better off dead or hurting themselves ) . All analyses were carried out using logistic regression . RESULTS Of guard members with PTSD in the last year , 61.7 % had at least 1 other psychopathology ; 20.2 % had at least 2 other co-occurring conditions . The most common co-occurring psychopathology was depression . While those with PTSD overall were 5.4 ( 95 % CI , 3.8 - 7.5 ) times more likely to report suicidality than those without PTSD , those who had at least 2 additional conditions along with PTSD were 7.5 ( 95 % CI , 3.0 - 18.3 ) times more likely to report suicidal ideation at some point in their lifetime than those with PTSD alone . CONCLUSIONS Soldiers with PTSD were at increased risk for suicidality , and , among those with PTSD , those with at least 2 additional conditions were at the highest risk of suicidal ideation . Future research should address the mechanisms that contribute to multimorbidity in this population and the appropriate treatment methods for this high-risk group Trauma risk management ( TRiM ) is an intensive posttraumatic stress disorder ( PTSD ) psychoeducational management strategy based on peer-group risk assessment developed by the UK Royal Navy ( RN ) . TRiM seeks to modify attitudes about PTSD , stress , and help-seeking and trains military personnel to identify at-risk individuals and refer them for early intervention . This quasiexperimental study found that TRiM training significantly improved attitudes about PTSD , stress , and help-seeking from TRiM-trained personnel . There was a nonsignificant effect on attitudes to seeking help from normal military support networks and on general health . Within both the military and civilian population s , stigma is a serious issue preventing help-seeking and reducing quality of life . The results suggest that TRiM is a promising antistigma program within organizational setting 
    Output:
    
Having a history of PTSD is associated with higher rates of morbidity and mortality and increased the risk for suicidal behavior .
The association between PTSD and suicidal behavior was confirmed by the presence of other risk factors and high rates of comorbidity .