Research Reports - The association between traumatic brain injury and suicide: Are kids at risk?

Am J Epidemiol. 2015 Jul 15;182(2):177-84

Richard YF, Swaine BR, Sylvestre MP, Lesage A, Zhang X, Feldman DE

Traumatic brain injury (TBI) in late adolescence and adulthood is associated with
a higher risk of suicide; however, it is unknown whether this association is also
present in people who sustained a TBI during childhood. The purpose of the
present study was to determine whether experiencing a TBI during childhood is a
risk factor for suicide later in life and to examine whether the risk of suicide
differs by sex or injury severity. A cohort of 135,703 children aged 0-17 years
was identified from the Quebec population-based physician reimbursement database
in 1987, and follow-up was conducted until 2008. Of the children in this cohort,
21,047 had sustained a TBI. Using a survival analysis with time-dependent
indicators of TBI, we found a higher risk of suicide for people who sustained a
TBI during childhood (hazard ratio (HR) = 1.49, 95% confidence interval (CI):
1.04, 2.14), adolescence (HR = 1.57, 95% CI: 1.09, 2.26), and adulthood (HR =
2.53, 95% CI: 1.79, 3.59). When compared with less severe injuries, such as
concussions and cranial fractures, more severe injuries, such as intracranial
hemorrhages, were associated with a higher risk of suicide (HR = 2.18 vs. 2.77,
respectively). Repeated injuries were associated with higher risks of suicide in
all age groups.

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