A new study published Wednesday in JAMA Psychiatry found that nearly one-fifth of U.S. service members who served in Iraq and Afghanistan have returned with some form of head injury or post-traumatic stress disorder (PTSD). A number of them have experienced both; the study claims that those who experienced brain injuries had a higher risk to develop PTSD.

The PTSD they develop could be related to the actual structural changes that occur in the brain caused by a blast-induced head injury. Dr. Dewleen Baker, who is an author of the study as well as research director at the Veterans Affairs Center of Excellence for Stress and Mental Health in San Diego, says these structural changes could be a risk factor for PTSD in the aftermath of a head injury.

The researchers reviewed 1,648 Marines from Southern California, as they went to war in 2008 and returned sometime before or during 2012. They assessed each soldier for PTSD and mental illnesses a month before deployment as well as three to six months after their return to the U.S. Some 20 percent of the participants reported having at least one traumatic brain injury (TBI) during their time in Afghanistan or Iraq. The researchers concluded that a brain injury increased the risk for developing PTSD from 23 percent to 34 percent. “Even when accounting for pre-deployment symptoms, prior TBI, and combat intensity, TBI during the most recent deployment is the strongest predictor of post-deployment PTSD symptoms,” the study states.

PTSD remains a major problem with veterans. According to Face the Facts USA of George Washington University, one in five veterans of Iraq and Afghanistan wars returned with a PTSD diagnosis, which is up to 300,000 veterans. Veteran suicides average up to almost one per day, potentially because mental health services for veterans have been stalled or lacking. However, a suicide data report issued by the Department of Veterans Affairs (VA) in 2012 found that the number of veteran suicides that occurred per day was actually up to 22.

Another study published in JAMA Psychiatry in July 2013, found that traumatic brain injury was also linked to veteran suicide. A person’s risk for suicide was much higher if they had several instances of TBI, which is common for military members.

Currently, treatment for PTSD typically involves cognitive-behavioral therapy as well as medication. Recently, a new study by Hungarian scientists found that talk therapy could actually improve the overall well-being of people with PTSD — their symptoms — as well as the underlying structural, or biological, changes that occur in their brains. The effective results of talk therapy are a sign of hope for many veterans suffering from mental illness, especially as the VA has a reputation for over-medicating, prescribing pills even if a patient doesn’t have a mental health diagnosis.

Sources:

Yurgil KA, Barkauskas DA, Vasterling JJ, et al. Association Between Traumatic Brain Injury and Risk of Post-traumatic Stress Disorder in Active-Duty Marines. [published online December 11, 2013]. JAMA.doi:10.1001/jamapsychiatry.2013.3080.

Bryan CJ, Clemans TA. Repetitive Traumatic Brain Injury, Psychological Symptoms, and Suicide Risk in a Clinical Sample of Deployed Military Personnel. JAMA. 2013;70(7):686-691.