Study Finds Link Between Traumatic Brain Injury and Premature Death

People who experienced a traumatic brain injury (TBI) were three times more likely to die prematurely than were matched control subjects, according to a study based on medical and population records of more than 2 million people in Sweden. The study, headed by Seena Fazel, M.D., a senior research fellow in the Department of Psychiatry at the University of Oxford in England, was published online today in JAMA Psychiatry.

The individuals were born in 1954 or later, and medical records covered the 40 years from 1969 to 2009. Within that group, 218,300 incurred TBIs, and 2,378 (1.1%) died at least six months or more after their injury. TBI was an independent risk factor for premature mortality, half of which was due to “external causes”—injuries, suicide, or assault. About 61 percent of those with TBI who died prematurely had lifetime substances abuse or other psychiatric diagnoses.

Yet those diagnoses may not explain these early deaths, said Robert Robinson, M.D., a professor of psychiatry at the University of Iowa, in an accompanying editorial. "[O]ne of the most likely explanations for the findings in the current study is the existence of personality characteristics of impulsiveness, risk-taking behaviors, and proneness to substance abuse,” Robinson said. “These patients incur a TBI and continue to demonstrate these behaviors after the TBI, which ultimately leads to a fatality.”

To read more about traumatic brain injury and psychiatric issues, see the Psychiatric News article, “When Traumatic Brain Injury Is Complicated by Personality Disorders.” Also see the book Management of Adults With Traumatic Brain Injury from American Psychiatric Publishing.

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Veterans With Depression Die Earlier Than Nondepressed Vets

Compared with nondepressed patients, patients with depression treated in the Department of Veterans Affairs health system died younger (71.1 versus 75.9) and had more years of potential life lost (13.4 versus 10.2) as a result of both natural and unnatural causes., according to a report in the August Psychiatric Services. Depending on the cause of death, depressed patients died between 2.5 and 8.7 years earlier and had 1.5 to 6.1 years of potential life lost compared with nondepressed patients, according to data from the U.S. Department of Veterans Affairs and the National Death Index. The data were used to calculate mean age of death and years of potential life lost associated with 13 causes of death among veterans with and without depression.

Lead author Kara Ziven, Ph.D., and colleagues say these findings have important implications for clinical practice, in that they suggest that improved quality of care may be needed to reduce early mortality among VA patients with depression.

The study, “Early Mortality and Years of Potential Life Lost Among Veteran Affairs Patients With Depression,” can be found here. For more information about veterans’ mental health see Psychiatric News here and here.

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