AURORA, Colo. – Military veterans with a history of traumatic brain injury (TBI) are more than twice as likely to die by suicide compared with veterans without such a diagnosis, according to a newly published study by researchers led by faculty from the CU School of Medicine.

The researchers reviewed electronic medical records of more than 1.4 million military veterans who received care from the Veterans Health Administration (VHA) between Oct. 1, 2005 and Sept. 30, 2015. Combining these records with National Death Index data, they evaluated the severity of TBI, and diagnoses of psychiatric and other medical conditions. Among those that died by suicide, the method was also analyzed.

After adjusting for psychiatric diagnoses, such as depression, the researchers found that those with moderate or severe TBI were 2.45 times as likely to die by suicide compared to those without a TBI diagnosis. Additionally, among suicide decedents, they report that the odds of using firearms as a means of suicide was significantly increased for those with moderate or severe TBI as compared to those without a history of TBI.

“Together, these findings underscore the importance of understanding Veterans’ lifetime history of TBI to prevent future deaths by suicide, and support the implementation of screening initiatives for lifetime history of TBI among all individuals utilizing the VHA,” the researchers write in the Journal of Head Trauma Rehabilitation. Moreover, the findings support research regarding lethal means safety among those with moderate to severe TBI.

The corresponding author of the article, which was published online this week, is Lisa A. Brenner, PhD, professor of physical medicine and rehabilitation at the CU School of Medicine and director of the Veterans Health Administration Rocky Mountain Mental Illness Research Education and Clinical Center, which supported the project.

During the period of time they studied, the rate of suicide was 86 per 100,000 person years for those with TBI compared with 37 per 100,000 person years for those without TBI. Of those in the sample who died by suicide, 68 percent used firearms. Veterans with moderate or severe TBIs had the highest proportion of suicides by firearms at 78 percent.

The authors note that the views, opinions, and findings of the article belong to the authors and should not be construed as official U.S. Department of Veterans Affairs positions, policies, or decisions. Brenner’s co-authors on the article are Trisha A. Hostetter, MPH; Claire A. Hoffmire, PhD; Jeri E. Forster, PhD; Rachel Sayko Adams, PhD, MPH, of Brandeis University; and Kelly A. Stearns-Yoder, MA. Hostetter, Hoffmire, Forster, and Stearns-Yoder are affiliated with University of Colorado Anschutz Medical Campus.