Prevalence of suicidal ideation and suicide attempt among patients with traumatic brain injury: A meta-analysis

Chen, Fei; Chi, Junting; Niu, Fang; Gao, Qianqian; Fan, Ming; Zhao, Li; Hu, Kaiyan; Zhao, Bing; Ma, Bin

doi:10.1016/j.jad.2022.01.024

Cited by 12 publications

(14 citation statements)

References 78 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Alternatively, suicide risk after TBI is accounted for by other factors such as depression and prior suicide risk behavior. Consistent with existing literature, depression and prior SI/SAs predicted later suicide risk, with prior SAs representing the strongest predictor,5,8,10,12 and headache severity predicted SAs above and beyond other predictors.…”

Section: Discussionsupporting

confidence: 85%

“…Using national surveillance data from the year 2020 as a comparison, among adults in the general population, SI prevalence was 4.9% while SA prevalence was 1.2% 7. Although suicide risk (SI and SAs) declined over time among persons with TBI, rates were still higher than rates in the general population; possible explanations for an elevated risk after TBI include frontal and frontal-subcortical circuitry dysfunction resulting in poor impulse control in decision-making, as well as elevated depression among persons with TBI 5…”

mentioning

confidence: 92%

“…Suicidal ideation (SI) and suicide attempts (SA) are risk factors for, and occur more frequently than, death by suicide. In a meta-analysis of 16 studies involving more than 1.4 million persons with TBI living around the globe who were at various points in time post-TBI (any severity), the prevalence of SI and SAs was 19.1% and 2.0%, respectively 5. In longitudinal research of persons followed for 20 years after sustaining a TBI, SI prevalence decreased over time (from 10.1% to 7.0%) as did SAs (from 1.7% to 0.8%) 6…”

mentioning

confidence: 99%

“…Literature reviews and epidemiological studies have identified several predictors of suicide risk (SI and SA), including younger age,2,6 prior military deployment,8,9 history of depression, posttraumatic stress disorder (PTSD), and substance use disorders,8–13 headache/pain,8,13,14 social isolation,14 and prior SI and SAs 5,8,10,12. Although some studies have reported an association between the number of TBIs and suicide risk, the relationship was nonsignificant after controlling for psychiatric disorders 8.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Examining the Relationship Between Sleep Apnea Diagnosis and Suicide Risk in Veterans With Traumatic Brain Injury: A VA TBI Model Systems Study

Silva

Gonzalez²,

Tang³

et al. 2023

Journal of Head Trauma Rehabilitation

View full text Add to dashboard Cite

Objective: Obstructive sleep apnea (OSA) is a common sleep disorder in people with traumatic brain injury (TBI). Although sleep disturbances have been associated with an increased risk of suicide compared with the general population, the relationship between OSA and suicide risk after TBI is not well documented. In this study, we hypothesized that OSA diagnosis would predict suicide risk in veterans with TBI. Setting: Five Veterans Affairs (VA) Polytrauma Rehabilitation Centers. Participants: Participants were drawn from the VA TBI Model Systems study, with follow-up interviews at year 1 (n = 392), year 2 (n = 444), year 5 (n = 498), or year 10 (n = 252) post-TBI (7.8%-14.5% follow-up attrition). Design: This was a retrospective analysis from observational data using logistic regression with repeated measurements. Suicide ideation and suicide attempts were examined as outcomes at each follow-up to evaluate the relationship between OSA and suicide risk after adjusting for other risk factors determined a priori via literature review. Main Measures: Suicidal ideation (Patient Health Questionnaire-9 item 9), suicide attempt during the past year (self-reported), and OSA diagnosis (self-reported). Results: Contrary to study hypotheses, OSA diagnosis had no statistically significant association with suicide ideation or attempt after accounting for known predictors. However, greater depression symptoms, headache severity, and pre-TBI suicidal ideation and attempts predicted suicide risk at follow-up after accounting for other predictors. Conclusions: Results of this study did not support a relationship between OSA and suicide risk, possibly due to methodological limitations of OSA measurement. Future research on this topic should include objective measures of OSA severity and OSA treatment including adherence. Although suicide is a low base rate occurrence, the impact is disastrous and further research is needed to mitigate suicide risk.

show abstract

Section: Discussionsupporting

confidence: 85%

mentioning

confidence: 92%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Examining the Relationship Between Sleep Apnea Diagnosis and Suicide Risk in Veterans With Traumatic Brain Injury: A VA TBI Model Systems Study

Silva

Gonzalez²,

Tang³

et al. 2023

Journal of Head Trauma Rehabilitation

View full text Add to dashboard Cite

show abstract

“…THE PSYCHOSOCIAL CONSEQUENCES of traumatic brain injury (TBI) are well documented, with many of those experiencing TBI noting decreased functioning and quality of life 1,2. Relatedly, many of those living with TBI have notable risk for negative psychiatric health outcomes, including depression and suicide 1,3,4. Moreover, prevalence of TBI is elevated among Veterans, due in part to both military (eg, combat exposure) and nonmilitary (eg, intimate partner violence) factors.…”

mentioning

confidence: 99%

Research Letter: Traumatic Brain Injury Among Veterans Accessing VA Justice-Related Services

Holliday¹,

Smith²,

Kinney³

et al. 2023

Journal of Head Trauma Rehabilitation

View full text Add to dashboard Cite

Objective: Risk for traumatic brain injury (TBI) within both the Veteran population and among individuals with a history of criminal justice involvement is notably high. Despite this, research examining TBI among Veterans with a history of criminal justice involvement (ie, justice-involved Veterans) remains limited. The sequelae of TBI can impact justice-involved Veterans' engagement in Department of Veterans Affairs (VA) justice-related services (ie, Veterans Justice Outreach and Health Care for Re-entry Veterans), thus potentially increasing risk for recidivism and impacting psychosocial functioning. As such, further understanding of TBI risk among justice-involved Veterans has the potential to inform the need for tailored screening and interventional efforts within VA justice-related service settings. We sought to better understand relative risk for TBI diagnosis among male and female Veteran recipients and nonrecipients of VA justice-related services. Setting: Electronic medical record data for Veterans accessing VA services from 2005 to 2018. Participants: 1517 447 (12.48% justice-involved) male and 126 237 (8.89% justice-involved) female Veterans. Design: A cross-sectional examination of national VA electronic medical record data. Sex-stratified analyses were conducted to examine relative risk of TBI diagnosis based on use of VA justice-related services. Main Measures: Documented TBI diagnosis was the main outcome. Covariates included VA service use, age, race, and ethnicity. Results: Both male and female Veterans using VA justice-related services were more likely to have a documented TBI diagnosis in their electronic VA medical record. Associations were attenuated, yet maintained significance, in all adjusted and sensitivity models. Conclusions: Given potential risk for TBI, enhancing and tailoring care for justice-involved Veterans may be critical to facilitating rehabilitation and reducing recidivism. Examination of existing services within justice-related settings and methods of augmenting care is an important next step.

show abstract

Adolescents Who Do Not Endorse Risk via the Patient Health Questionnaire Before Self-Harm or Suicide

Flores,

Kahn,

Penfold

et al. 2024

JAMA Psychiatry

View full text Add to dashboard Cite

ImportanceGiven that the Patient Health Questionnaire (PHQ) item 9 is commonly used to screen for risk of self-harm and suicide, it is important that clinicians recognize circumstances when at-risk adolescents may go undetected.ObjectiveTo understand characteristics of adolescents with a history of depression who do not endorse the PHQ item 9 before a near-term intentional self-harm event or suicide.Design, Setting, and ParticipantsThis was a retrospective cohort study design using electronic health record and claims data from January 2009 through September 2017. Settings included primary care and mental health specialty clinics across 7 integrated US health care systems. Included in the study were adolescents aged 13 to 17 years with history of depression who completed the PHQ item 9 within 30 or 90 days before self-harm or suicide. Study data were analyzed September 2022 to April 2023.ExposuresDemographic, diagnostic, treatment, and health care utilization characteristics.Main Outcome(s) and Measure(s)Responded “not at all” (score = 0) to PHQ item 9 regarding thoughts of death or self-harm within 30 or 90 days before self-harm or suicide.ResultsThe study included 691 adolescents (mean [SD] age, 15.3 [1.3] years; 541 female [78.3%]) in the 30-day cohort and 1024 adolescents (mean [SD] age, 15.3 [1.3] years; 791 female [77.2%]) in the 90-day cohort. A total of 197 of 691 adolescents (29%) and 330 of 1024 adolescents (32%), respectively, scored 0 before self-harm or suicide on the PHQ item 9 in the 30- and 90-day cohorts. Adolescents seen in primary care (odds ratio [OR], 1.5; 95% CI, 1.0-2.1; P = .03) and older adolescents (OR, 1.2; 95% CI, 1.0-1.3; P = .02) had increased odds of scoring 0 within 90 days of a self-harm event or suicide, and adolescents with a history of inpatient hospitalization and a mental health diagnosis had twice the odds (OR, 2.0; 95% CI, 1.3-3.0; P = .001) of scoring 0 within 30 days. Conversely, adolescents with diagnoses of eating disorders were significantly less likely to score 0 on item 9 (OR, 0.4; 95% CI, 0.2-0.8; P = .007) within 90 days.Conclusions and RelevanceStudy results suggest that older age, history of an inpatient mental health encounter, or being screened in primary care were associated with at-risk adolescents being less likely to endorse having thoughts of death and self-harm on the PHQ item 9 before a self-harm event or suicide death. As use of the PHQ becomes more widespread in practice, additional research is needed for understanding reasons why many at-risk adolescents do not endorse thoughts of death and self-harm.

show abstract

Prevalence of suicidal ideation and suicide attempt among patients with traumatic brain injury: A meta-analysis

Cited by 12 publications

References 78 publications

Examining the Relationship Between Sleep Apnea Diagnosis and Suicide Risk in Veterans With Traumatic Brain Injury: A VA TBI Model Systems Study

Examining the Relationship Between Sleep Apnea Diagnosis and Suicide Risk in Veterans With Traumatic Brain Injury: A VA TBI Model Systems Study

Research Letter: Traumatic Brain Injury Among Veterans Accessing VA Justice-Related Services

Adolescents Who Do Not Endorse Risk via the Patient Health Questionnaire Before Self-Harm or Suicide

Contact Info

Product

Resources

About