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Journal Article

Citation

Brenner LA, Ignacio RV, Blow FC. J. Head Trauma Rehabil. 2011; 26(4): 257-264.

Affiliation

VISN 19 Mental Illness Research Education and Clinical Center (MIRECC), Denver, Colorado (Dr Brenner); School of Medicine, University of Colorado, Denver (Dr Brenner); Veteran Affairs Serious Mental Illness Treatment Research and Evaluation Center (SMITREC), Ann Arbor, Michigan (Ms Ignacio and Dr Blow); University of Michigan Ann Arbor (Ms Ignacio and Dr Blow).

Copyright

(Copyright © 2011, Lippincott Williams and Wilkins)

DOI

10.1097/HTR.0b013e31821fdb6e

PMID

21734509

Abstract

OBJECTIVE: : To examine associations between history of traumatic brain injury (TBI) diagnosis and death by suicide among individuals receiving care within the Veterans Health Administration (VHA). METHOD: : Individuals who received care between fiscal years 2001 to 2006 were included in analyses. Cox proportional hazards survival models for time to suicide, with time-dependent covariates, were utilized. Covariance sandwich estimators were used to adjust for the clustered nature of the data, with patients nested within VHA facilities. Analyses included all patients with a history of TBI (n = 49626) plus a 5% random sample of patients without TBI (n = 389053). Of those with a history of TBI, 105 died by suicide. Models were adjusted for demographic and psychiatric covariates. RESULTS: : Veterans with a history of TBI were 1.55 (95% confidence interval [CI], 1.24-1.92) times more likely to die by suicide than those without a history of TBI. Analyses by TBI severity were also conducted, and they suggested that in comparison to those without an injury history, those with (1) concussion/cranial fracture were 1.98 times more likely (95% CI, 1.39-2.82) to die by suicide and (2) cerebral contusion/traumatic intracranial hemorrhage were 1.34 times more likely (95% CI, 1.09-1.64) to die by suicide. This increased risk was not explained by the presence of psychiatric disorders or demographic factors. CONCLUSIONS: : Among VHA users, those with a diagnosis of TBI were at greater risk for suicide than those without this diagnosis. Further research is indicated to identify evidence-based means of assessment and treatment for those with TBI and suicidal behavior.


Language: en

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