Bernanke Alyssa, Kimbrel Nathan A, Beckham Jean C, Bourassa Kyle J
Feinberg School of Medicine, Northwestern University.
VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham VA Health Care System; VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine.
Psychiatry Res. 2025 Sep;351:116654. doi: 10.1016/j.psychres.2025.116654. Epub 2025 Jul 25.
Veterans die by suicide at almost twice the rate of non-veterans, and risks for suicide can be further increased after sustaining traumatic brain injury (TBI). This is notable, given that over 20 % of post-9/11 Veterans are estimated to have experienced TBI. Better understanding risk for suicidal thoughts and behaviors (STBs) would allow for improved screening processes and targeted treatment approaches. In this study, we use data from 823 veterans who served after September 11, 2001 and participated in the VISN 6 MIRECC's Post-Deployment Mental Health Study. In total, 511 (62.1 %) veterans reported at least one TBI during their lifetime and 241 (29.3 %) reporting at least one TBI during military deployment. Veterans had more STBs at baseline if they also reported more lifetime TBIs (β = 0.45, CI [0.18, 0.72], p < .001) or deployment TBI (β = 0.53, CI [0.16, 0.90], p = .005). When examining change over 12 years, veterans showed greater increases in STBs if they reported more lifetime TBIs (β = 0.34, CI [0.12, 0.55], p = .002) or deployment TBI (β = 0.62, CI [0.33, 0.91], p < .001). These associations remained when accounting for baseline mental health conditions (depressive symptoms, posttraumatic stress disorder symptoms, and lifetime trauma burden). All reported results accounted for age, gender, self-reported race/ethnic group, and education. Findings suggest that TBI is associated with increases in STBs and emergence of STBs over time. To better differentiate risk, screening measures and treatment for STBs should consider whether brain injury occurred in combat.
退伍军人自杀率几乎是非退伍军人的两倍，而在遭受创伤性脑损伤（TBI）后，自杀风险可能会进一步增加。鉴于据估计，2001年9月11日之后退伍的军人中有超过20%经历过TBI，这一点值得关注。更好地了解自杀念头和行为（STB）的风险将有助于改进筛查流程和针对性的治疗方法。在本研究中，我们使用了823名在2001年9月11日之后服役并参与VISN 6 MIRECC部署后心理健康研究的退伍军人的数据。总共有511名（62.1%）退伍军人报告在其一生中至少经历过一次TBI，241名（29.3%）报告在军事部署期间至少经历过一次TBI。如果退伍军人报告的一生中TBI次数更多（β = 0.45，CI [0.18, 0.72]，p <.001）或部署期间TBI次数更多（β = 0.53，CI [0.16, 0.90]，p =.005），那么他们在基线时的STB就更多。在考察12年期间的变化时，如果退伍军人报告的一生中TBI次数更多（β = 0.34，CI [0.12, 0.55]，p =.002）或部署期间TBI次数更多（β = 0.62，CI [0.33, 0.91]，p <.001），他们的STB增加幅度就更大。在考虑基线心理健康状况（抑郁症状、创伤后应激障碍症状和一生的创伤负担）时，这些关联仍然存在。所有报告的结果都考虑了年龄、性别、自我报告的种族/族裔群体和教育程度。研究结果表明，TBI与STB的增加以及随着时间推移STB的出现有关。为了更好地区分风险，STB的筛查措施和治疗应考虑脑损伤是否发生在战斗中。
