title: Prior injury and motor vehicle crash as risk factors for youth suicide.
abstract: We conducted a case-control study to determine whether adolescents and young adults who have been in a motor vehicle crash or hospitalized for unintentional and intentional injury are at greater risk for suicide. Cases were 700 Washington State residents age 16-35 with a driver's license who died of suicide during 1987-1989. Controls were 3,494 licensed drivers matched by age, sex, and zip code. Using two different databases, we were able to determine the past incidence of in-state injury hospitalizations and motor vehicle crashes for all subjects. Overall, the incidence of suicide was tenfold higher among those with a past hospitalization for injury. Many of these admissions were for suicide attempts [odds ratio (OR) = 56, 95% confidence interval (CI) = 27-120], but the risk of suicide was also higher among those hospitalized for unintentional injuries (OR = 5.0, 95% CI = 2.2-11.5) and assaults (OR = 4.5, 95% CI = 1.1-18). The relative risk for suicide was 2.7 (95% CI = 2.0-3.5) for those with prior injury as a driver in a motor vehicle crash and 2.9 (95% CI = 2.2-3.8) for those with involvement in a single vehicle crash. Many unintentional injury hospitalizations and a proportion of motor vehicle crashes in younger adults may represent unrecognized suicide attempts.
authors.affiliation: Department of Pediatrics, University of Washington, Seattle.
authors.forename: D C
authors.initials: DC
authors.lastname: Grossman
authors.forename: R
authors.initials: R
authors.lastname: Soderberg
authors.forename: F P
authors.initials: FP
authors.lastname: Rivara
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D001334:Automobile Driving; D016022:Case-Control Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D008297:Male; D016017:Odds Ratio; D012307:Risk Factors; D013405:Suicide / Q000706:statistics & numerical data*; D014861:Washington / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology*