Suicidality and Injury of the Prefrontal Cortex in Multiple Incidents of Mild Traumatic Brain Injury—In Reply

In Reply In response to our recent findings of increased suicidality among deployed military personnel with multiple mild traumatic brain injuries (mTBIs),¹ Riechers et al ask if a stronger relationship of suicidality exists among military personnel with mTBI marked by loss of consciousness (LOC). We examined data from the 133 of 161 participants (82.6%) diagnosed with traumatic brain injury subsequent to their most recent index injury. Seven of the 60 personnel (11.7%) with LOC vs 15 of 73 (20.5%) without LOC reported lifetime incidence of suicidal ideation (χ²₁ = 1.882; P = .17). Similarly, 3 of 60 personnel (5.0%) with LOC vs 9 of 73 (12.3%) without LOC reported suicidal ideation during the past year (χ²₁ = 2.155; P = .14). Lifetime and recent incidences of suicidal ideation were therefore reported less often among traumatic brain injury cases with LOC, although this difference was not statistically significant in this relatively small subgroup.