Article

OBJECTIVE: To determine whether severity of head and extracranial injuries (ECI)
is associated with suicidal ideation (SI) or suicide attempt (SA) after traumatic
brain injury (TBI). DESIGN: Factors associated with SI and SA were assessed in
this inception cohort study using data collected 1, 2, and 5 years post-TBI from
the National Trauma Data Bank and Traumatic Brain Injury Model Systems (TBIMS)
databases. SETTING: Level I trauma centers, inpatient rehabilitation centers, and
the community. PARTICIPANTS: Participants with TBI from 15 TBIMS Centers with
linked National Trauma Data Bank trauma data (N=3575). INTERVENTIONS: Not
applicable. MAIN OUTCOME MEASURES: SI was measured via the Patient Health
Questionnaire 9 (question 9). SA in the last year was assessed via interview. ECI
was measured by the Injury Severity Scale (nonhead) and categorized as none,
mild, moderate, or severe. RESULTS: There were 293 (8.2%) participants who had SI
without SA and 109 (3.0%) who had SA at least once in the first 5 years
postinjury. Random effects logit modeling showed a higher likelihood of SI when
ECI was severe (odds ratio=2.73; 95% confidence interval, 1.55-4.82; P=.001).
Drug use at time of injury was also associated with SI (odds ratio=1.69; 95%
confidence interval, 1.11-2.86; P=.015). Severity of ECI was not associated with
SA. CONCLUSIONS: Severe ECI carried a nearly 3-fold increase in the odds of SI
after TBI, but it was not related to SA. Head injury severity and less severe ECI
were not associated with SI or SA. These findings warrant additional work to
identify factors associated with severe ECI that make individuals more
susceptible to SI after TBI.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS