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Suicide after traumatic brain injury: a population study.

T W Teasdale1, A W Engberg

  • 1Department of Psychology, University of Copenhagen, Njalsgade 88, 2300 Copenhagen S, Denmark. teasdale@psy.ku.dk

Journal of Neurology, Neurosurgery, and Psychiatry
|September 19, 2001
PubMed
Summary

Patients with traumatic brain injuries (TBIs) face an elevated suicide risk, particularly those with more severe injuries. This increased risk is linked to factors like substance misuse and the injury

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Area of Science:

  • Neuroscience
  • Public Health
  • Epidemiology

Background:

  • Traumatic brain injury (TBI) is a significant public health concern.
  • Understanding the long-term risks associated with TBI, including suicide, is crucial for patient care.

Purpose of the Study:

  • To determine the incidence and risk of suicide among individuals with various types of traumatic brain injuries.

Main Methods:

  • Analysis of a Danish population register of hospital admissions from 1979-1993.
  • Inclusion of patients with concussion, cranial fracture, or cerebral contusion/traumatic intracranial hemorrhage.
  • Identification of all deaths within the study period to calculate suicide rates and standardized mortality ratios.

Main Results:

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  • Elevated suicide rates were observed across all TBI diagnostic groups compared to the general population (Standardized Mortality Ratios: 3.0 for concussion, 2.7 for cranial fracture, 4.1 for contusion/hemorrhage).
  • Suicide risk was higher in females than males and decreased in individuals injured before age 21 or after age 60.
  • Substance misuse co-diagnosis was associated with increased suicide rates; more severe injuries (contusion/hemorrhage) showed a significantly greater risk (Hazard Ratios: 1.42-1.50).

Conclusions:

  • Mild TBI patients have an increased suicide risk, potentially due to co-occurring psychiatric conditions and psychosocial disadvantages.
  • More severe TBI cases indicate that the physical, psychological, and social consequences of the injury directly contribute to suicide risk.
  • No specific risk period for suicide was identified after the initial TBI.