Tuesday, August 14, 2018

Risk of Suicide Increases After TBI, Study Finds

Individuals who have experienced a traumatic brain injury (TBI) appear to be at a higher risk of suicide than those who have not experienced such an injury, according to a study appearing today in JAMA. The report suggests that suicide risk is particularly elevated during the first six months after medical contact for the injury. Further, individuals who were diagnosed with a psychiatric disorder and/or engaged in deliberate self-harm after experiencing a TBI had a higher risk of suicide than those with TBI only.

Trine Madsen, Ph.D., of the Danish Institute of Suicide Prevention and colleagues conducted a retrospective cohort study using nationwide registers that included more than 7.4 million people aged 10 years and older living in Denmark in 1980. These individuals were followed up until their dates of death or emigration from Denmark or December 31, 2014, whichever came first.

Of the total population included in the analysis, 423,502 individuals (5.7%) were diagnosed with a mild TBI, 24,221 (0.3%) with skull fracture, and 120,100 (1.6%) with severe TBI. Among the 34,529 people who died by suicide, 3,536 (10.2%) had previously been diagnosed with TBI (2,578 men; 958 women), Madsen and colleagues reported.

“The absolute suicide rate in Denmark was 21 per 100,000 person-years in the 1980-2014 period, but it was almost twice as high among individuals with TBI, 41 per 100,000 person-years,” the authors wrote. Additional analysis revealed that the risk of suicide was higher for individuals with severe TBI, numerous medical contacts for TBI, and longer hospital stays.

“Suicide is preventable, but only with recognition of risk and prompt intervention,” Lee Goldstein, M.D., Ph.D., of Boston University School of Medicine and Ramon Diaz-Arrastia, M.D., Ph.D., of the University of Pennsylvania Perelman School of Medicine wrote in an accompanying editorial. “The results reported by Madsen et al. point to an important clinical triad—TBI history, recent injury (especially long hospital stays), and more numerous postinjury medical contacts for TBI—that serves as ‘red flags’ for increased suicide risk. Notably, the results of this study indicate that increased suicide risk is relevant across all TBI severity levels, including the far more common mild injuries.”

For related information, see Management of Adults With Traumatic Brain Injury from APA Publishing.

(Image: iStock/Steve Debenport)


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