Related Experiment Video
Updated: Jul 15, 2025
Author Spotlight: Developing Precise and Clinically Relevant Models for Studying Secondary Degeneration in Traumatic Optic Neuropathy
Published on: November 29, 2024
Suicide Attempts and Ideation Among Veterans/Service Members and Non-Veterans Over 5 Years Following Traumatic Brain
Daniel W Klyce1, Paul B Perrin, Jessica M Ketchum
1Mental Health Service, Central Virginia Veterans Affairs VA Health Care System, Richmond (Drs Klyce, Perrin, and Campbell and Ms Vargas); Departments of Physical Medicine and Rehabilitation (Dr Klyce), Rehabilitation Counseling (Dr Gary), and Psychology (Ms Vargas),Virginia Commonwealth University, Richmond; Rehabilitation Psychology Service, Sheltering Arms Institute, Richmond, Virginia (Dr Klyce); School of Data Science, University of Virginia, and Department of Psychology, University of Virginia, Charlottesville (Dr Perrin); Department of Research, Craig Hospital, Englewood, Colorado (Dr Ketchum); Rehabilitation and Extended Care Service, Minneapolis VA Health Care System, and Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Dr Finn); Brain Injury Research Center, TIRR Memorial Hermann, Houston, Texas, Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, and Department of Physical Medicine and Rehabilitation, University of Texas Health Sciences Center at Houston, Houston (Dr Juengst); Department of Psychiatry, Massachusetts General Hospital, Boston, and Department of Psychiatry, Harvard Medical School, Boston, Massachusetts (Dr Fisher); Rehabilitation Research Center, Santa Clara Valley Medical Center, San Jose, California (Dr Pasipanodya); and Department of Psychology, University of Alabama, Birmingham, and Ackerson and Associates, Vestavia Hills, Alabama (Dr Niemeier).
Objective:
This study compared rates of suicide attempt (SA) and suicidal ideation (SI) during the first 5 years after traumatic brain injury (TBI) among veterans and service members (V/SMs) in the Veterans Affairs (VA) and the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) Model Systems National Databases to each other and to non-veterans (non-Vs) in the NIDILRR database.
Setting:
Twenty-one NIDILRR and 5 VA TBI Model Systems (TBIMS) inpatient rehabilitation facilities in the United States.
Participants:
Participants with TBI were discharged from rehabilitation alive, had a known military status recorded (either non-V or history of military service), and successful 1-, 2-, and/or 5-year follow-up interviews completed between 2009 and 2021. The year 1 cohort included 8737 unique participants (8347 with SA data and 3987 with SI data); the year 2 (7628 participants) and year 5 (4837 participants) cohorts both had similar demographic characteristics to the year 1 cohort.
Design:
Longitudinal design with data collected across TBIMS centers at 1, 2, and 5 years post-injury.
Main Outcomes And Measures:
History of SA in past year and SI in past 2 weeks assessed by the Patient Health Questionnaire-9 (PHQ-9). Patient demographics, injury characteristics, and rehabilitation outcomes were also assessed.
Results:
Full sample rates of SA were 1.9%, 1.5%, and 1.6%, and rates of SI were 9.6%, 10.1%, and 8.7% (respectively at years 1, 2, and 5). There were significant differences among groups based on demographic, injury-related, mental/behavioral health, and functional outcome variables. Characteristics predicting SA/SI related to mental health history, substance use, younger age, lower functional independence, and greater levels of disability.
Conclusions:
Compared with participants with TBI in the NIDILRR system, higher rates of SI among V/SMs with TBI in the VA system appear associated with risk factors observed within this group, including mental/behavioral health characteristics and overall levels of disability.
