HealthDay News — Veterans diagnosed with a traumatic brain injury (TBI) are at a higher risk for suicide in comparison with those without a TBI diagnosis, especially when the severity is moderate to severe, according to a study published online July 30 in the Journal of Head Trauma Rehabilitation.

Trisha A. Hostetter, MPH, of the VHA Rocky Mountain Mental Illness Research, Education, and Clinical Center in Aurora, Colorado, and colleagues performed a retrospective cohort study to examine the association between TBI and suicide as well as suicide method among individuals receiving Veterans Health Administration care during the fiscal years of 2006 through 2015. Participants included veterans with a TBI diagnosis during and prior to the study window (215,610 veterans) compared with a 20% random sample of those without TBI (1,187,639 veterans).

The researchers found that the risk for suicide was 2.19 times higher for those with TBI than for those without and was still significant when accounting for covariates (hazard ratio, 1.71). When mild TBI was compared with no TBI, the mild cases had a significantly increased risk for suicide after adjusting for covariates (hazard ratio, 1.62). A significant difference in death by suicide was observed when comparing moderate-to-severe TBI to no TBI after adjusting for covariates (hazard ratio, 2.45). Of those who died by suicide, 68% used firearms, and veterans with moderate-to-severe TBI showed the highest proportion of suicide by firearms (78%), followed by those with no TBI (70%) and those with mild TBI (61%).

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“This large-scale study supports previous work and indicates that there continues to be risk for both psychiatric conditions and suicide among those with a history of TBI receiving VHA care,” the authors write. “Additional efforts are needed to identify injury histories, as well as to introduce interventions, including lethal means safety, into rehabilitative settings.”

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