Citation

Miller GF, Zhou H, Peterson AB, Swedo E, Holland K, Kresnow MJ. Inj. Prev. 2022; ePub(ePub): ePub.

Copyright

(Copyright © 2022, BMJ Publishing Group)

DOI

10.1136/ip-2022-044697

PMID

36600521

Abstract

INTRODUCTION: Negative outcomes, including suicidal ideation/attempts, are a major public health concern, particularly among individuals who sustain a traumatic brain injury (TBI). TBI is associated with high rates of postinjury substance use, psychiatric disorders, post-traumatic stress disorder and sleep disturbances. This study examines the mediation effects of substance use, psychiatric disorder and sleep disorder on the associations between TBI and suicidal ideation/attempts.

METHODS: A matched case-control study using data from MarketScan databases for private health insurance and Medicaid from October 2015 to December 2018 estimated the association between TBI and suicidal ideation/attempts using a mediation approach. Individuals less than 65 years of age were included.

RESULTS: In the Medicaid sample, psychiatric disorders mediated 22.4% of the total effect between TBI and suicidal ideation/attempt, while substance use disorders other than opioid use disorder mediated 7.47%. In the private health insurance sample, psychiatric disorders mediated 3.97% of the total effect, opioid use disorders mediated 2.08% of the total effect and sleep disorder mediated 1.25% of the total effect.

CONCLUSIONS: Mediators explained less than 30% of the relationship between TBI and suicidal ideation/attempt.

FINDINGS reinforce the importance of primary prevention of TBI and monitoring patients with a TBI for risk of suicide in the first 6-12 months following injury.

Language: en

Keywords

Case-Control Study; Psychological; Traumatic Brain Injury