The Risk of Suicide Attempts After Head Injury: A Matched UK Population-Based Cohort Study

Area of Science:

• Neuroscience
• Public Health
• Epidemiology

Background:

• Traumatic brain injuries (TBIs) are linked to increased suicide risk.
• The risk of suicide following other head injuries in the general population is not well understood.

Purpose of the Study:

• To determine if individuals with head injuries face a higher risk of suicide compared to those without.
• To identify risk factors and subgroups associated with suicide attempts after head injuries.

Main Methods:

• A 20-year population-based matched cohort study using national health records.
• Matched 389,523 adults with head injuries to 1,489,675 controls (1:4 ratio) by age, sex, and location.
• Analyzed suicide attempts and deaths using Cox proportional hazards regression.

Main Results:

• Adults with head injuries had a 21% higher risk of suicide attempts (adjusted HR 1.21).
• Increased risk was observed within the first 12 months post-injury, associated with deprivation and mental health history.
• The adjusted hazard ratio for death by suicide was initially significant (0.74) but became nonsignificant after controlling for competing risks.

Conclusions:

• Head injuries are associated with an elevated risk of suicide attempts, irrespective of prior mental health conditions.
• Clinical practice and health policy should focus on suicide risk assessment and prevention for head injury patients, especially within the first year.
• Further investigation into tailored suicide prevention strategies for individuals with head injuries is warranted.