title: Psychiatric diagnoses, mental health utilization, high-risk behaviors, and self-directed violence among veterans with comorbid history of traumatic brain injury and substance use disorders.
abstract: OBJECTIVE
  To describe various characteristics of veterans with co-occurring histories of traumatic brain injury (TBI) and substance use disorder (SUD) for purposes of hypothesis generation.
  
  
  METHODS
  Archival data collected over a period of 4 years.
  
  
  METHODS
  Sixty-five veterans across eras of service with confirmed histories of TBI and SUD.
  
  
  METHODS
  : Demographic and TBI information were obtained from an archival clinical database. Electronic medical records were reviewed for mental health utilization, psychiatric diagnoses, self-directed violence, and risk-taking behaviors.
  
  
  RESULTS
  In addition to a SUD, veterans were reported to have an average of 3 additional psychiatric diagnoses and a median of 3 TBIs per person. All utilized various mental health services in addition to substance use treatment. Individuals were found to have engaged in a variety of risky behaviors. There were significant associations between suicidal ideation and assaultive behaviors, as well as between suicide attempt and impulsivity.
  
  
  CONCLUSIONS
  This study describes a sample of veterans with co-occurring histories of TBI, SUD, risk-taking behaviors, and self-directed violence. More research is needed to examine these complex interrelationships and to identify specific risk factors for intervention/prevention strategies.
authors.affiliation: VISN 19 Mental Illness Research, Education and Clinical Center (MIRECC), Denver, Colorado 80220, USA. jennifer.olson-madden@va.gov
authors.forename: Jennifer H
authors.initials: JH
authors.lastname: Olson-Madden
authors.forename: Jeri E
authors.initials: JE
authors.lastname: Forster
authors.forename: Joseph
authors.initials: J
authors.lastname: Huggins
authors.forename: Alexandra
authors.initials: A
authors.lastname: Schneider
mesh_terms: D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000150:complications*; D006801:Humans; D001523:Mental Disorders / Q000150:complications* / Q000628:therapy; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D012309:Risk-Taking; D016728:Self-Injurious Behavior / Q000150:complications*; D019966:Substance-Related Disorders / Q000150:complications*; D014481:United States; D014728:Veterans / Q000523:psychology*