Does a history of mild traumatic brain injury increase suicide risk in veterans with PTSD?

Abstract

This finding highlights the importance of screening and treating military personnel and veterans for PTSD. Future explication of the impact of TBI-related impairments on suicide risk will be critical as we strive to ensure safety and optimize care for our military personnel and veterans.

Co-Occurring Traumatic Brain Injury, PTSD Symptoms, and Alcohol Use in Veterans

“…Primarily, the present study provided additional data on the potential influence of past TBI on current psychiatric symptoms. This area of concern has received much attention in the literature over the years, including studies on the higher frequency of co-occurrence of diagnoses (Carlson et al, 2010;Hoge et al, 2008) as well as increased severity of symptoms of these diagnoses (Barnes et al, 2012;Ragsdale et al, 2013). The present findings supported previous findings that participants with head trauma with LOC had more severe affective symptoms across disorder and across assessor (self-report and clinician-rated) compared to control participants.…”

“…Despite the hypothesized deleterious effects of these three conditions in concert, no studies have investigated the three together. Based on the previous findings, we hypothesized that the presence of mTBI would be related to elevated physical health concerns, due to injuries related to the mTBI, as well as mildly elevated symptoms of PTSD and related conditions, as noted earlier, while controlling for demographic differences (Barnes et al, 2012;Ragsdale et al, 2013). The influence of mTBI on SUD is harder to predict, with the initial findings suggesting increased substance use over time (Adams et al, 2012;Parry-Jones et al, 2006).…”

“…For example, a positive screening of mTBI has been associated with higher rates of co-occurring posttraumatic stress disorder (PTSD) and depression (Carlson et al, 2010;Hoge at al., 2008), even after controlling for combat exposure (Hoge et al, 2008). In addition, some studies have found that veterans with PTSD with a history of mTBI demonstrate more severe PTSD symptoms than veterans with PTSD without a history of mTBI (Barnes et al, 2012;Ragsdale et al, 2013). Although these studies have not supported a direct relation between mTBI and the most severe psychiatric symptoms (e.g., suicide ideation) (Barnes et al, 2012), the higher likelihood of symptoms of PTSD and depression put veterans with a history of mTBI at high risk.…”

“…In addition, some studies have found that veterans with PTSD with a history of mTBI demonstrate more severe PTSD symptoms than veterans with PTSD without a history of mTBI (Barnes et al, 2012;Ragsdale et al, 2013). Although these studies have not supported a direct relation between mTBI and the most severe psychiatric symptoms (e.g., suicide ideation) (Barnes et al, 2012), the higher likelihood of symptoms of PTSD and depression put veterans with a history of mTBI at high risk. In fact, specific treatment recommendations have been proposed for veterans with PTSD and mTBI to address the increased complexity and potential severity of symptoms in this population (Capehart and Bass, 2012)..…”

“…Of these cases, 75 % of TBIs were classified as mild (mTBI), characterized by confusion or disorientation for less than 24 h, loss of consciousness for up to 30 min, memory loss for less than 24 h, and normal brain imaging results (Ragsdale et al, 2013). Given the rates of TBI among veterans, the Department of Defense and Department of Veteran Affairs (VA) have made the identification, assessment, and treatment of veterans with TBI a major priority within their related treatment facilities (Barnes et al, 2012;Capehart and Bass, 2012).…”