Nonfatal firearm injuries raise the risk of mental and substance use disorders (SUD), a study in JAMA Psychiatry suggests.
Katherine A. Koh, M.D., M.Sc., of Massachusetts General Hospital, and colleagues used data from Marketscan, a large database comprising enrollees and dependents with employer-sponsored insurance, to compare claims from 2007 with claims from 2019. The researchers matched 6,498 survivors of firearm injury to 32,490 control individuals and 12,489 family members of survivors to 62,445 control individuals. They then measured changes in diagnoses per 1,000 people for trauma-related, mood, anxiety, neuropsychiatric, and psychotic disorders postinjury relative to preinjury, compared with matched controls.
Overall, there was a higher prevalence of diagnoses before injury among survivors but not among family members relative to controls. “[This] could suggest risk factors for firearm injury, and thus opportunities for prevention,” the researchers wrote. “To what extent diagnoses represent preexisting conditions uncovered through care remains unknown.”
After nonfatal firearm injury, psychiatric disorders increased among survivors, including 77% for mood disorders, 146% for trauma-related disorders, 57% for anxiety disorders, and 73% to 305% for psychotic, neuropsychiatric, and other disorders.
The researchers also measured changes in SUD diagnoses. These also rose after firearm injury, including 99% for tobacco use disorder, 186% for alcohol use disorder, and 49% to 195% for opioid, cannabis, sedative, stimulant, and other substance use disorders.
“[A]lthough postinjury prescription opioids remain a potential mechanism for misuse, clinicians should remain vigilant for alcohol, tobacco, and other substance misuse postinjury,” Koh and colleagues wrote.
There were larger increases in psychiatric and SUDs among survivors with more severe firearm injuries, such as those requiring intensive care unit treatment, compared with individuals who had less severe injuries.
“Meeting mental health needs postinjury may help attenuate repeat firearm injuries and associated suffering,” the researchers wrote.
For related information, see the Psychiatric News article “Psychiatrists Have Tools to Prevent Gun Violence.”
(Image: Getty Images/iStock/Radka Danailova)
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