Identifying group‐based patterns of suicidal ideation over the first 10 years after moderate‐to‐severe TBI

Klyce, Daniel W.; Perrin, Paul B.; Fisher, Lauren; Juengst, Shannon B.; Bergquist, Thomas F.; Rabinowitz, Amanda R.; Wagner, Amy K.; Bombardier, Charles H.; Gary, Kelli W.; Giacino, Joseph T.; Zafonte, Ross

doi:10.1002/jclp.23282

Cited by 4 publications

(4 citation statements)

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“…Overall, our findings are consistent with prior research indicating that SI and suicidal behaviors among people with TBI can be linked to demographic, medical, and psychosocial factors including premorbid and concurrent psychiatric illness, age at injury, and poor postinjury psychosocial functioning 3,13,34. There have been mixed findings in previous research regarding the association between suicide-related outcomes following TBI and measures of either functional performance or the extent of extracranial injury 8,35–37. Although lower FIM Motor and Cognitive scores were associated with SI across all groups at each time point, the clinical differences in median scores between groups were difficult to discern, suggesting that concurrent measures of overall disability might be more useful to consider in clinical practice and future research regarding suicide-related outcomes and TBI.…”

Section: Discussionsupporting

confidence: 88%

“…3,13,34 There have been mixed findings in previous research regarding the association between suicide-related outcomes following TBI and measures of either functional performance or the extent of extracranial injury. 8,[35][36][37] Although lower FIM Motor and Cognitive scores were associated with SI across all groups at each time point, the clinical differences in median scores between groups were difficult to discern, suggesting that concurrent measures of overall disability might be more useful to consider in clinical practice and future research regarding suicide-related outcomes and TBI.…”

Section: Sexmentioning

confidence: 99%

“…[4][5][6] Reports of lifetime rates of SA after TBI have ranged from 8% to 26%, with 1.6% of individuals reporting SA in the past year. 1,7,8 Reported rates of SI after TBI range from 7% to 33%, with 25% of individuals experiencing SI in the first year after injury. [9][10][11] Variability in methodological approaches to investigating suicide-related outcomes after TBI (eg, measures/assessments, definition of terms, and characterization of participants) has yielded mixed findings regarding risk factors, but typically implicates a range of sociocultural, behavioral and physical health, injury-related, and functional variables.…”

mentioning

confidence: 99%

“…Individuals with TBI are 2 to 4 times more likely to die by suicide than the general population 4–6. Reports of lifetime rates of SA after TBI have ranged from 8% to 26%, with 1.6% of individuals reporting SA in the past year 1,7,8. Reported rates of SI after TBI range from 7% to 33%, with 25% of individuals experiencing SI in the first year after injury 9–11.…”

mentioning

confidence: 99%

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Suicide Attempts and Ideation Among Veterans/Service Members and Non-Veterans Over 5 Years Following Traumatic Brain Injury: A Combined NIDILRR and VA TBI Model Systems Study

Klyce,

Perrin,

Ketchum

et al. 2023

Journal of Head Trauma Rehabilitation

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Objective: This study compared rates of suicide attempt (SA) and suicidal ideation (SI) during the first 5 years after traumatic brain injury (TBI) among veterans and service members (V/SMs) in the Veterans Affairs (VA) and the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) Model Systems National Databases to each other and to non-veterans (non-Vs) in the NIDILRR database. Setting: Twenty-one NIDILRR and 5 VA TBI Model Systems (TBIMS) inpatient rehabilitation facilities in the United States. Participants: Participants with TBI were discharged from rehabilitation alive, had a known military status recorded (either non-V or history of military service), and successful 1-, 2-, and/or 5-year follow-up interviews completed between 2009 and 2021. The year 1 cohort included 8737 unique participants (8347 with SA data and 3987 with SI data); the year 2 (7628 participants) and year 5 (4837 participants) cohorts both had similar demographic characteristics to the year 1 cohort. Design: Longitudinal design with data collected across TBIMS centers at 1, 2, and 5 years post-injury. Main Outcomes and Measures: History of SA in past year and SI in past 2 weeks assessed by the Patient Health Questionnaire-9 (PHQ-9). Patient demographics, injury characteristics, and rehabilitation outcomes were also assessed. Results: Full sample rates of SA were 1.9%, 1.5%, and 1.6%, and rates of SI were 9.6%, 10.1%, and 8.7% (respectively at years 1, 2, and 5). There were significant differences among groups based on demographic, injury-related, mental/behavioral health, and functional outcome variables. Characteristics predicting SA/SI related to mental health history, substance use, younger age, lower functional independence, and greater levels of disability. Conclusions: Compared with participants with TBI in the NIDILRR system, higher rates of SI among V/SMs with TBI in the VA system appear associated with risk factors observed within this group, including mental/behavioral health characteristics and overall levels of disability.

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