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Repeated traumatic brain injury increased suicide risk in military personnel

Repetitive traumatic brain injury contributes to suicidal thoughts and risk for suicide in military personnel, results from a recent study in JAMA Psychiatry suggest.

“Traumatic brain injuries probably serve as a chronic risk factor for suicidal behaviors,” researchers said, “most likely because of their association with a number of well-established suicide risk factors frequently seen with military populations, including psychiatric disorders, impaired problem solving, and aggression.”

The suicide rate for US military personnel is rising and currently the second leading cause of death, according to the researchers. The study estimates the prevalence of traumatic brain injury (TBI), which is associated with increased risk for suicidal ideation, to be about 8% to 20% in military personnel deployed to Iraq and Afghanistan. Study researchers recruited 161 participants in the military who were referred for evaluation and treatment of suspected head injury. Researchers used the Behavioral Health Measure Questionnaire–20, the PTSD Checklist–Military Version, and the Suicide Behaviors Questionnaire–Revised to assess suicide ideation and depression levels. The participants also were examined for concussive symptoms.

Results showed that an increased incidence of suicidal thoughts and behavior was associated with the number of TBIs (no TBIs, 0%; one TBI, 6.9%; and multiple TBIs, 21.7%; P=.009). When the effects of depression, PTSD, and TBI symptom severity were controlled for, results showed that the number of TBIs was associated with greater suicide risk (P=.03). Researchers also found a significant interaction between depression and cumulative TBIs (P=.04).

“Results of the current study supported our hypothesis that military personnel who have sustained more TBIs report more severe psychological symptoms and greater suicide risk. In addition, the significant interaction of depression severity and number of TBIs suggests that the effects of depression on suicide risk are augmented by cumulative TBIs,” the researchers said.

Disclosure: The researchers report no relevant financial disclosures.