JAMA Publishes New Study Showing that TBI Increases the Risk of Suicide
A new study published in the Journal of the American Medical Association adds to a growing body of evidence pointing to traumatic brain injuries, of all levels of severity, as an important risk factor for suicide.
The significance of the study is discussed in an opinion in the same issue of JAMA. Both the increased risk of suicide and the prevalence of depression following TBI have been discussed in prior posts in this blog.
The most recent findings further highlight the importance of continuous monitoring and treatment of depression symptoms, as urged in the literature discussed in our prior posts. The JAMA study was a retrospective population-based study that included all 7.4 million individuals aged 10 years and older living in Denmark from 1980 to 2014, representing more than 160 million person-years of follow up data. Setting it apart from other similar studies, the investigators included adjustments for relevant covariates, including preexisting psychiatric illness and preexisting nonfatal self-harm actions.
As in other studies, the investigators found that the risk of suicide was particularly elevated during the first six months following medical contact for TBI. Although the increased risk was somewhat greater for “severe” TBIs, there was increased suicide risk across all TBI severity levels, the including so-called “mild” TBIs (concussions.)
As the authors of the opinion piece point out, we do not fully understand how a TBI, a highly heterogeneous condition, increases the risk of suicide. “The answers,” they say, “ are undoubtedly multifactorial and complex.” The most important comment in the opinion appears at the end. “Suicide is preventable, but only with recognition of risk and prompt intervention.” The JAMA study should remove any doubt about the risk. Hopefully, this will lead to more attention and intervention.