Loss of Consciousness, Depression, Posttraumatic Stress Disorder, and Suicide Risk among Deployed Military Personnel with Mild Traumatic Brain Injury

Objective: To identify clinical variables associated with suicidality in military personnel with mild traumatic brain injury (mTBI) while deployed to
Iraq.
Setting: Outpatient TBI clinic on a US military base in Iraq.
Participants: Military personnel (N = 158) referred to an outpatient TBI clinic for a standardized intake evaluation, 135 (85.4%) who had a diagnosis of mTBI and 23 (14.6%) who did not meet criteria for TBI.
Main Measures: Suicidal Behaviors Questionnaire–Revised, Depression subscale of the Behavioral Health Measure-20, Posttraumatic Stress Disorder Checklist-Military Version, Insomnia Severity Index, self-report questionnaire, and clinical interview addressing TBI-related symptoms.
Results: Among patients with mTBI, increased suicidality was significantly associated with depression and the interaction of depression with posttraumatic stress disorder symptoms. Longer duration of loss of consciousness was associated with decreased likelihood for any suicidality.
Conclusion: Assessment after TBI in a combat zone may assist providers in identifying those at risk for suicidality and making treatment recommendations for service members with mTBI.