| Title: |
Associations of Military-Related Traumatic Brain Injury With New-Onset Mental Health Conditions and Suicide Risk |
| Authors: |
Brenner, Lisa A.; Forster, Jeri E.; Gradus, Jaimie L.; Hostetter, Trisha A.; Hoffmire, Claire A.; Walsh, Colin G.; Larson, Mary Jo; Stearns-Yoder, Kelly A.; Adams, Rachel Sayko |
| Source: |
JAMA Network Open ; volume 6, issue 7, page e2326296 ; ISSN 2574-3805 |
| Publisher Information: |
American Medical Association (AMA) |
| Publication Year: |
2023 |
| Description: |
Importance Research to identify the direct and indirect associations of military-related traumatic brain injury (TBI) with suicide has been complicated by a range of data-related challenges. Objective To identify differences in rates of new-onset mental health conditions (ie, anxiety, mood, posttraumatic stress, adjustment, alcohol use, and substance use disorders) among soldiers with and without a history of military-related TBI and to explore the direct and indirect (through new-onset mental health disorders) associations of TBI with suicide. Design, Setting, and Participants This retrospective cohort study used data from the Substance Use and Psychological Injury Combat Study (SUPIC) database. Demographic, military, and health data from the Department of Defense within SUPIC were compiled and linked with National Death Index records to identify deaths by suicide. Participants included US Army soldiers who returned from an Afghanistan or Iraq deployment. Data were analyzed from September to December 2022. Exposures Military-related TBI. Main Outcomes and Measures The outcome of interest was suicide. Secondary outcomes were incidence of new-onset mental health conditions. Mediation analyses consisted of accelerated failure time (AFT) models in conjunction with the product of coefficients method. The 6 new-onset mental health diagnosis categories and the 2 or more categories variable were each considered separately as potential mediators; therefore, a total of 14 models plus the overall AFT model estimating the total effect associated with TBI in suicide risk were fit. Results The study included 860 892 soldiers (320 539 soldiers [37.2%] aged 18-24 at end of index deployment; 766 454 [89.0%] male), with 108 785 soldiers (12.6%) with at least 1 documented TBI on their military health record. Larger increases in mental health diagnoses were observed for all conditions from before to after documented TBI, compared with the matched dates for those without a history of TBI, with increases observed for mood (67.7% vs ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1001/jamanetworkopen.2023.26296 |
| Availability: |
https://doi.org/10.1001/jamanetworkopen.2023.26296; https://jamanetwork.com/journals/jamanetworkopen/articlepdf/2807787/brenner_2023_oi_230754_1689947087.08646.pdf |
| Accession Number: |
edsbas.194F040B |
| Database: |
BASE |