Multiple Head Injuries Raise Soldiers' Suicide Risk, Study Finds

20 percent of those with two or more brain traumas had thoughts of killing themselves

By Mary Elizabeth Dallas

Wednesday, May 15, 2013

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WEDNESDAY, May 15 (HealthDay News) -- Military service members who sustain more than one mild traumatic brain injury may be at much greater risk of suicide, according to a new study.
Researchers at the University of Utah found that the risk for suicidal thoughts or behaviors increased for a lifetime, not just short-term, among those with multiple head injuries.
"Up to now, no one has been able to say if multiple [traumatic brain injuries], which are common among combat veterans, are associated with higher suicide risk," study author Craig Bryan, an assistant professor of psychology, said in a university news release. "This study suggests they are, and it provides valuable information for professionals treating wounded combat servicemen and servicewomen to help manage the risk of suicide."
A traumatic brain injury is caused by a bump, blow or jolt to the head, or a penetrating head injury that disrupts brain function, according to the U.S. Centers for Disease Control and Prevention. Although these injuries can range from mild to severe, most are mild.
The study, published online May 15 in the journal JAMA Psychiatry, involved 161 patients who suffered a possible traumatic brain injury while on duty in Iraq over the course of six months. The patients were mostly men with an average age of 27 and more than six years of military service. They were treated at an outpatient traumatic brain injury clinic at a combat support hospital.
Traumatic brain injury was assessed, and the service members were divided into three groups based on the number of injuries sustained during their lifetime: none, one and two or more.
"An important feature of the study is that by being on the ground in Iraq, we were able to compile a unique data set on active military personnel and head injuries," said Bryan, who also is associate director of the university's National Center for Veterans Studies. "We collected data on a large number of service members within two days of impact."
The patients also were surveyed about their symptoms of depression, post-traumatic stress syndrome, concussions and suicidal thoughts and behaviors.
One in five patients who had sustained two or more traumatic brain injuries reported suicidal thoughts or preoccupation with suicide at some point in their past, the study revealed.
Of those who suffered one traumatic brain injury, 6.9 percent reported having suicidal thoughts. None of the participants without a traumatic brain injury had such thoughts.
Of the patients with two or more traumatic brain injuries, 12 percent had suicidal thoughts during the past year. In contrast, 3.4 percent of those with one brain injury had suicidal thoughts.
The study also showed that multiple traumatic brain injuries were associated with a significant increase in depression, post-traumatic stress disorder (PTSD) and severity of concussive symptoms. But only the increase in depression severity predicted an increased risk for suicide, the researchers said.
"That head injury and resulting psychological effects increase the risk of suicide is not new," Bryan said. "But knowing that repetitive [traumatic brain injuries] may make patients even more vulnerable provides new insight for tending to military personnel over the long-term, particularly when they are experiencing added emotional distress in their lives."
The researchers said more extensive research involving larger groups of people is needed to confirm the results, since the study found only an association between brain injuries and suicide risk in military personnel and did not prove a cause-and-effect relationship.
Suicide is the second-leading cause of death among U.S. military personnel.

SOURCE: University of Utah, news release, May 15, 2013

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