Управление болью может снизить риск суицидальных мыслей у ветеранов

Among US service members and veterans, pain interference and perceived burdensomeness are consistently associated with suicidal ideation (SI), according to study results published in The Journal of Pain. Researchers examined the associations between combat injury, post-deployment pain, and SI in service members before and at 3 time points after a combat deployment. In a separate sample, researchers also examined ongoing combat-injury-related pain and SI cross-sectionally at long-term follow-up approximately 6 years post-enlistment. Using data from 2 cohorts within the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS), the longitudinal Pre/Post Deployment Study (PPDS), and the STARRS Longitudinal Study (LS1), researchers selected eligible participants. The PPDS evaluated associations between combat injury, pain intensity, pain interference, pain catastrophizing, interpersonal theory of suicide (IPTS) constructs, and SI before deployment and at 3 and 9 months after return from Afghanistan. LS1 assessed similar relationships approximately 6 years after enlistment, focusing on pain attributed to combat injury vs other causes. Treatment and prevention of suicidal ideation in this population may benefit from a focus on effective pain management. A total of 4645 participants from the PPDS (mean age, 26.96 years; 94.7% men; 64.9% Non-Hispanic White) and 5003 participants from the LS1 studies were included for final analysis. In PPDS, 5.5% of service members sustained combat injuries, but combat injury was not associated with SI at 3 months (OR, 1.49; 95% CI, 0.79-2.81) or 9 months (OR, 1.50; 95% CI, 0.92-2.43) after deployment. At 3 months, perceived burdensomeness (OR, 2.16; 95% CI, 1.26-3.73) and pain interference (OR, 2.28; 95% CI, 1.23-4.23) were independently associated with greater odds for SI. At 9 months, perceived burdensomeness (OR, 2.15; 95% CI, 1.53-3.02), pain interference (OR, 1.60; 95% CI, 1.13-2.27), and pain catastrophizing (OR, 1.57; 95% CI, 1.04-2.38) also were associated with increased odds for SI. In the LS1 cohort initial model, 3.3% of participants attributed pain to combat injury. However, combat injury–related pain was not associated with SI (OR, 1.22; 95% CI, 0.61-2.41). In the fully adjusted multivariable model containing IPTS and pain variables there was a negative association between SI and injury-related pain (OR, 0.87; 95% CI, 0.39-1.92), but this relationship was not significant. Instead, pain interference (OR, 1.55; 95% CI, 1.14-2.11), acquired suicide capability (OR, 1.62; 95% CI, 1.36-1.92), and especially perceived burdensomeness (OR, 9.69; 95% CI, 6.84-13.73) were independently associated with SI. In exploratory post-hoc cross-sectional analysis, including adjustment for IPTS factors attenuated the association between pain interference and SI (OR reduced from 2.21 to 1.55), suggesting that perceived burdensomeness partially mediates this relationship. Study limitations include reliance on self-reported measures, the inability to evaluate longitudinal mediation because post-deployment IPTS measures were unavailable, and relatively few participants with combat injury–related pain or SI. The study authors concluded, “Treatment and prevention of suicidal ideation in this population may benefit from a focus on effective pain management.” Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures. This article originally appeared on Clinical Pain Advisor References: Wild MG, Campbell-Sills L, Sun X, et al. Combat injury, pain, and suicidal ideation in U.S. army service members and veterans. J Pain. 2026;48:106390. doi:10.1016/j.jpain.2026.106390