Military veterans with a history of traumatic brain injury (TBI) are more than twice as likely to die by suicide compared to veterans without a TBI diagnosis, according to a new study appearing in the Journal of Head Trauma Rehabilitation.
In addition, among all veterans who died by suicide, the odds of using firearms as a means of suicide was significantly increased for those with moderate or severe TBI compared to those without a history of TBI.
For the study, a research team led by the University of Colorado (CU) School of Medicine looked at the electronic medical records of more than 1.4 million military veterans who had received care from the Veterans Health Administration (VHA) between Oct. 1, 2005 and Sept. 30, 2015.
Combining these records with National Death Index data, the team assessed the severity of TBI, and diagnoses of psychiatric and other medical conditions. Among those that died by suicide, the method was also analyzed.
After adjusting for psychiatric diagnoses, such as depression, the research team discovered that those with moderate or severe TBI were still 2.45 times more likely to die by suicide compared to those without a TBI diagnosis.
“Together, these findings underscore the importance of understanding Veterans’ lifetime history of TBI to prevent future deaths by suicide, and support the implementation of screening initiatives for lifetime history of TBI among all individuals utilizing the VHA,” the researchers write.
The findings also support the need for more research into suicide safety among those with moderate to severe TBI.
During the period of time they studied, the rate of suicide was 86 per 100,000 person years for those with TBI compared with 37 per 100,000 person years for those without TBI.
“Person years” is a type of measurement which takes into account both the number of people in the study and the amount of time each person spends in the study.
Overall, among those in the sample who died by suicide, 68 percent used firearms. Veterans with moderate or severe TBIs had the highest proportion of suicides by firearms at 78 percent.
The corresponding author of the article is Lisa A. Brenner, PhD, professor of physical medicine and rehabilitation at the CU School of Medicine and director of the Veterans Health Administration Rocky Mountain Mental Illness Research Education and Clinical Center, which supported the project.