@article{ref1,
title="Association between traumatic brain injury and suicidality using a mediation approach and MarketScan",
journal="Injury prevention",
year="2022",
author="Miller, Gabrielle F. and Zhou, Hong and Peterson, Alexis B. and Swedo, Elizabeth and Holland, Kristin and Kresnow, Marcie-jo",
volume="ePub",
number="ePub",
pages="ePub-ePub",
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. <br><br>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. <br><br>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. <br><br>CONCLUSIONS: Mediators explained less than 30% of the relationship between TBI and suicidal ideation/attempt. <br><br>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.<p /> <p>Language: en</p>",
language="en",
issn="1353-8047",
doi="10.1136/ip-2022-044697",
url="http://dx.doi.org/10.1136/ip-2022-044697"
}