Blast injury and chronic psychiatric disability in military personnel: Exploring the association beyond posttraumatic stress disorder

Abstract

Introduction

Blast injuries are common among military personnel, yet their long-term psychiatric consequences, beyond posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI), remain underexplored. This study investigates the association between blast injuries and non-PTSD psychiatric conditions, including psychotic, neurocognitive, mood, anxiety, adjustment and personality disorders resulting in functional impairment.

Methods

Data were collected from three cross-referenced registries that span the continuum of trauma care from 2006 to 2021. Demographics, injury mechanisms, and injury settings were sourced from the Israel Defense Forces Trauma Registry; hospitalization data from the Israeli National Trauma Registry and psychiatric-related disability was assessed utilizing long-term disability claims documented by the Israel Ministry of Health Rehabilitation Department. Logistic regression was employed to evaluate the association between blast injuries and psychiatric morbidity, with results presented as adjusted odds ratios (OR) and 95 % confidence intervals (CI).

Results

Among 7646 military personnel (91.3 % male, median age: 20 years), 1503 (19.7 %) sustained blast injuries. Overall, 44 (0.6 %) were diagnosed with non-PTSD psychiatric-related disability. Prevalence was higher among those with blast injuries (1.0 % vs. 0.5 %; p = 0.016). Blast injuries were associated with a more than two-fold increase in odds for psychiatric morbidity (Adjusted OR 2.44, 95 % CI: 1.07–5.59) after adjusting for blast injury severity and presence of head injury.

Conclusions

Blast injury was significantly associated with long-term psychiatric morbidity, independent of head injury and additional confounders. These findings suggest that proactive mental health screening and interventions should be considered for individuals experiencing blast injuries. Future research should explore the mechanisms underlying this association.