Effect of the polytrauma clinical triad on suicide risk among U.S. veterans and active-duty soldiers.

BACKGROUND

The polytrauma clinical triad (PCT)-co-occurring posttraumatic stress disorder (PTSD), traumatic brain injury (TBI), and chronic pain-is common among U.S. service members and veterans. While known to result in worse clinical outcomes, the effect of the PCT on suicide in military populations remains unknown. The current study examined the effect of the PCT on suicidal ideation and attempts in U.S. veterans and service members.

METHOD: In Study 1, veterans (N = 351) completed self-reports of PTSD symptoms and chronic pain and clinician interviews of TBI and suicidal ideation and attempts. In study 2, Army soldiers (N = 8558) completed self-reports of PTSD symptoms, chronic pain, TBI, and suicidal ideation and attempts across four assessments spanning from 1-month prior to deployment to 9-months post-deployment.

RESULTS

The PCT was more prevalent in veterans (30.09%) than service members (2.51%), and was associated with greater odds of suicidal ideation in veterans (OR = 4.11) when compared with only two conditions. When compared with one or no conditions, the PCT was associated with greater odds of suicidal ideation (ORs = 2.06-2.94) and attempts (ORs = 4.06-4.40) in service members. PTSD seemed to drive this effect.

CONCLUSION

Findings support the PCT as a potentially important risk factor for suicide in both current and former military members. Future research should attempt to understand the impact of the PCT on mechanisms of suicide risk and suicide risk screening should be prioritized in polytrauma clinics where patients with the PCT are likely to be seen.