Multiple Brain Injuries Create Greater Risk of Suicide
People with a history of multiple concussions have greater risk of suicidal thoughts than people with only one or no concussions, according to a new study.
The study showed that soldiers who had multiple traumatic brain injuries were three times more likely to have suicidal thoughts compared to soldiers who had only a single TBI.
Suicide is now the second most common cause of death in the military. In 2008, there were 16 suicides per 100,000 service members. That represented a 50% increase in suicides since 2001, according a study from the RAND corporation.
Traumatic brain injuries are likely behind the rising suicide rates as more soldiers suffer from the signature wound of war, the researchers explained in the study published in the journal JAMA Psychiatry. Although TBIs have been linked to suicide, it was unclear whether having cumulative concussions lead to greater risks, according to lead author Craig Bryan, PsyD, of the University of Utah National Center for Veterans' Studies.
Bryan and his colleagues studied 157 service members and 4 contractors who were treated at a military hospital in Iraq for suspected brain injuries. Eighteen soldiers said they'd never been diagnosed with a TBI in the past, 58 had been diagnosed with one TBI previously, and 85 had experienced multiple brain injuries in their lifetime. Most TBIs were mild.
Patients without a history of previous concussions did report having suicidal thoughts. In soldiers who had a single previous concussion, 6.9% reported having suicidal thoughts at some point in their life, and 3.4% had such thoughts in the past year. The numbers were much greater for soldiers with cumulative concussions: 21.7% reported lifetime suicidal thoughts and 12% reported having suicidal thoughts in the previous year. The more concussions a solider had, the greater their risk was for suicidal thoughts, even after adjusting for depression, PTSD, and injury severity.
Although the study was limited to soldiers, Bryan said their results may have implications for other groups at risk of multiple concussions, like athletes. Brain injuries in football and other contact sports have received increasing attention in the past few years, as more athletes suffer from depression and cognitive deficits associated with multiple TBIs.
However, the study doesn't imply that concussions cause suicidal thoughts, Bryan explained to the Chicago Tribune. The majority of soldiers with TBI didn't report suicidal thoughts in his study. Furthermore having suicidal thoughts doesn't necessarily mean someone will commit suicide, especially if adequate treatments are available.
Growing suicide rates in soldiers led 53 congressmembers to send a letter to Defense Secretary Chuck Hagel and Veterans Affairs Secretary Eric Shinseki, asking them to investigate the link between IED-blast brain injuries and suicides.
"As we prepare to bring 34,000 troops home from Afghanistan this year and the entirety of the 66,000 members strong force by the end of 2014, we must gain a better understanding of the psychological impact of injuries from IEDs," they wrote.
Bryan C, et al. Repetitive traumatic brain injury, psychological symptoms, and suicide risk in a clinical sample of deployed military personnel. JAMA Psychiatry 2013; 1-6. doi:10.1001/jamapsychiatry.2013.1093.