title: Self-inflicted traumatic brain injury: Characteristics and outcomes.
abstract: OBJECTIVE
  To characterize the population of those receiving inpatient rehabilitation who sustained a traumatic brain injury (TBI) secondary to a suicide attempt and identify differences between such individuals and a demographically-matched control group (n = 230) of those whose TBIs were of an unintentional aetiology.
  
  
  METHODS
  Analysed cases were identified from the TBI Model Systems National Database. Based on ICD-9-CM external cause-of-injury codes, 79 participants incurred a TBI secondary to a suicide attempt. An approximate 1 : 3 matched case-control (age, gender, race, injury year) design was chosen to make statistical comparisons.
  
  
  RESULTS
  Those who sustained a TBI secondary to a suicide attempt had greater pre-existing psychiatric and psychosocial problems (substance use problems (p = 0.01) prior suicide attempt (p < 0.0001), psychiatric hospitalization (p = 0.014) and non-productive activity (p = 0.014)), required more resources during acute and rehabilitative hospitalizations (i.e. charges per day; p = 0.024, p = 0.047) and had greater disability at the time of discharge, even after controlling for injury severity (p = 0.022).
  
  
  CONCLUSIONS
  Individuals who sustained TBIs secondary to a suicide attempt had increased pre-injury psychiatric and psychosocial problems and poorer outcomes at discharge than those who incurred unintentional injuries. For these individuals, acute and rehabilitation charges per day were higher and could not be accounted for by injury severity.
authors.affiliation: VA VISN Mental Illness Research Education and Clinical Center, Denver, Colorado 80223, USA. lisa.brenner@va.gov
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Brenner
authors.forename: Nichole E
authors.initials: NE
authors.lastname: Carlson
authors.forename: Cynthia
authors.initials: C
authors.lastname: Harrison-Felix
authors.forename: Teresa
authors.initials: T
authors.lastname: Ashman
authors.forename: Flora M
authors.initials: FM
authors.lastname: Hammond
authors.forename: Ronald E
authors.initials: RE
authors.lastname: Hirschberg
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000453:epidemiology / Q000523:psychology* / Q000534:rehabilitation; D016022:Case-Control Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D012307:Risk Factors; D013406:Suicide, Attempted / Q000523:psychology*; D016896:Treatment Outcome; D014948:Wounds, Gunshot / Q000453:epidemiology / Q000523:psychology* / Q000534:rehabilitation