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TBI Boosts Risk of Mental Health Disorders After Combat Injury

January 08, 2020

Sustaining a traumatic brain injury (TBI) in military combat increased the risk of a handful of mental health conditions compared with a critical combat injury without TBI, according to a study published online in the journal Military Medicine.

“In our cohort of military personnel who were severely injured in combat, we found that most patients (70.6%) were diagnosed with at least one mental health disorder during the multi-year follow-up period (median years, 4.1),” researchers wrote. “The unique risk—as represented by odds ratios and incidence rate ratios—for five mental health diagnosis categories was consistently greater among patients who sustained a TBI.”

The retrospective cohort study included 4980 members of US Army, Navy, Marines Corps, and Air Force who were severely injured in combat during military operations in Iraq and Afghanistan. The prevalence of moderate or severe TBI among participants was 31.6%. The most common cause of injury was an explosion.

The adjusted odds ratio associated with TBI was 3.24 for a cognitive disorder, 1.40 for a mood disorder, 1.39 for an adjustment disorder, 1.35 for post-traumatic stress disorder, and 1.27 for an anxiety disorder, according to the study. The analysis also identified an association between TBI and an increased number of mental health diagnoses. 

“Combat-associated TBI may have a broad effect on several mental health conditions among critically injured combat casualties,” researchers wrote. “Early recognition and treatment for trauma-associated mental health are crucial to improving outcomes among service personnel as they transition to post-deployment care in the Department of Defense, Department of Veterans Affairs, or community health systems.” 

Jolynn Tumolo


Chin DL, Zeber JE. Mental Health Outcomes Among Military Service Members After Severe Injury in Combat and TBI [published online ahead of print, 2019 Dec 31]. Mil Med. 2019;usz440. doi:10.1093/milmed/usz440

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