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. 2025 Apr:184:515-521.
doi: 10.1016/j.jpsychires.2025.03.026. Epub 2025 Mar 19.

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

Elad Epshtein  1 , Shay Shraga  2 , Irina Radomislensky  3 , Sarah L Martindale  4 , Shir Bushinsky  5 , Avi Benov  6 , Ofer Almog  7 , Avishai M Tsur  8 , Tomer Talmy  9 ; Israel Trauma Group
Collaborators, Affiliations
Free article

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

Elad Epshtein et al. J Psychiatr Res. 2025 Apr.
Free article

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.

Keywords: Blast injuries; Disability; Mental health; Military personnel; Psychiatric morbidity; Rehabilitation.

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Conflict of interest statement

Declaration of competing interest The authors declare no conflicts of interest. This study was performed as part of the Israel Defense Forces Trauma and Combat Medicine Branch efforts to improve the quality of combat casualty care.