Soldiers with traumatic brain injuries have high rates of mental health disorders, UMass study finds

American soldiers who suffered moderate or severe traumatic brain injuries are more likely to experience a range of mental health disorders compared with soldiers with other serious injuries, according to a new study by researchers at the University of Massachusetts Amherst.

The research was published in the journal Military Medicine and is believed to be the “largest and broadest look at severe combat injury in the military and associated mental health outcomes,” according to a UMass news release.

Lead investigator David Chin, an assistant professor of health policy and management, and coauthor John Zeber, an associate professor and program head of health policy and management, examined the cases of 4,980 service members who were severely injured during combat in Iraq and Afghanistan between 2002 and 2011, the release said.

Nearly a third of them suffered moderate or severe traumatic brain injury, known as TBI for short.

Chin found that 71 percent of all the severely injured soldiers were diagnosed with at least one of five mental health conditions: post-traumatic stress disorder, anxiety and mood disorders, adjustment reactions, schizophrenia and other psychotic disorders, and cognitive disorders, the release said.

Previous research had reported a much lower rate of 42 percent, the release said.

Chin’s research also showed that diagnoses for every mental health condition were higher among the cases of traumatic brain injury than other severe injuries.

“A central takeaway is that severe TBI is associated with a greater risk of mental health conditions – not just PTSD,” Chin said in the news release. “Our findings suggest that patients who are critically injured in combat and sustain severe TBI have particularly high rates of mental health disorders.”

The research also found that the risk for post-traumatic stress disorder is higher – not lower, as previous investigators have assumed – among combat soldiers with more severe TBI, the release said.

“There was a common belief that having a severe TBI resulted in an amnestic effect on PTSD – the injuries were so severe that the patients have no memory of the event and that put them at lower risk of having mental health outcomes," said Chin. “This data showed to the contrary.”

Officials said the UMass study followed the soldiers’ care for a median period of more than four years, while earlier studies typically only followed the soldiers for one year. Even with that longer time frame, Chin said, the study “definitely underestimates” the prevalence of mental health conditions among severely injured soldiers, according to the news release.

“Our finding of the high incidence of mental health conditions in critically injured combat casualties, particularly those with TBI, may have implications for many stakeholders,” the study states. “Policymakers may consider the potential for undetected long-term mental health disability, particularly among patients receiving late diagnoses.”

According to the Associated Press, the Defense Department reported more than 375,000 incidents of TBI between the years 2000 and 2018. The AP reported that 50 US service members suffered traumatic brain injuries in Iran’s missile strike on Jan. 8, and as of Tuesday, 31 of the 50 had since returned to duty.