Research Reports - Rates and predictors of suicidal ideation during the first year after traumatic brain injury

Am J Public Health. 2014 Jul;104(7)

Mackelprang JL(1), Bombardier CH, Fann JR, Temkin NR, Barber JK, Dikmen SS

Objectives. We examined rates of suicidal ideation (SI) after traumatic brain
injury (TBI) and investigated whether demographic characteristics, preinjury
psychiatric history, or injury-related factors predicted SI during the first year
after injury. Methods. We followed a cohort of 559 adult patients who were
admitted to Harborview Medical Center in Seattle, Washington, with a complicated
mild to severe TBI between June 2001 and March 2005. Participants completed
structured telephone interviews during months 1 through 6, 8, 10, and 12 after
injury. We assessed SI using item 9 of the Patient Health Questionnaire (PHQ-9).
Results. Twenty-five percent of the sample reported SI during 1 or more
assessment points. The strongest predictor of SI was the first PHQ-8 score (i.e.,
PHQ-9 with item 9 excluded) after injury. Other significant multivariate
predictors included a history of a prior suicide attempt, a history of bipolar
disorder, and having less than a high school education. Conclusions. Rates of SI
among individuals who have sustained a TBI exceed those found among the general
population. Increased knowledge of risk factors for SI may assist health care
providers in identifying patients who may be vulnerable to SI after TBI.

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