Association between chronic pain, suicidal thoughts and behaviour in military and veteran populations

Chronic pain is defined as pain that persists for a period of three or more months. It can be caused by an injury, disease or following a surgery, and it affects over 3.2 million Australians. These costs amount to over $70 billion annually. Beyond pain, chronic pain also impacts work, sleep and relationships, usually occurring alongside other conditions such as depression and fatigue.

Chronic pain is a considerable burden on the general community, but it especially impacts current and ex-serving people in the defence force. Serving and ex-serving military populations can be exposed to considerable physical and psychological risks, which occasionally result in physical injury and disability. Brain injury can also impact cognitive function and a range of cognitive disorders, such as post-traumatic stress disorder (PTSD). In some cases, these impacts culminate in suicidal thoughts and behaviours.

In collaboration with Painaustralia, we worked to better understand the relationship between chronic pain and suicide in currently serving and ex-serving military populations. A particular area of interest was comparing suicide rates in defence and veteran populations with those of other citizens.

What did we do?‍

We conducted a systematic desktop review to explore the association between chronic pain and suicidal thoughts and behaviours in military, veterans and general populations. 33 studies were eligible for inclusion in the review.

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What did we find?

The prevalence of chronic pain among current and ex-serving military populations is 27-57% (that is, between 3 and 6 out of 10) and chronic pain is more burdensome in military personnel compared to civilian populations
Current and ex-serving military populations experience chronic pain alongside a range of other physical, cognitive and emotional disorders including post-traumatic stress disorder (PTSD) and mild traumatic brain injury
Chronic pain is one of many factors that contribute to suicidal ideation and behaviours in military and veteran cohorts
Chronic pain is one of many factors that contribute to suicidal ideation and behaviours in military and veteran cohorts. Other factors such as female gender, sleep disturbance and marital and employment status also play a role.

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What’s next/recommendations

A key conclusion of the review was that chronic pain and its impact on individuals should be considered when evaluating risk of suicide in military and veteran cohorts.

A better understanding of the prevalence and impact of chronic pain in serving defence force personnel, veterans and their families will inform ongoing improvement in prevention, intervention, and management of pain and its consequences, including self harm and suicide.

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