Rates and predictors of suicidal ideation during the first year after traumatic brain injury.
OBJECTIVE
We examined rates of suicidal ideation (SI) after traumatic brain injury (TBI) and investigated whether demographic characteristics, preinjury psychiatric history, or injury-related factors predicted SI during the first year after injury.


METHODS
We followed a cohort of 559 adult patients who were admitted to Harborview Medical Center in Seattle, Washington, with a complicated mild to severe TBI between June 2001 and March 2005. Participants completed structured telephone interviews during months 1 through 6, 8, 10, and 12 after injury. We assessed SI using item 9 of the Patient Health Questionnaire (PHQ-9).


RESULTS
Twenty-five percent of the sample reported SI during 1 or more assessment points. The strongest predictor of SI was the first PHQ-8 score (i.e., PHQ-9 with item 9 excluded) after injury. Other significant multivariate predictors included a history of a prior suicide attempt, a history of bipolar disorder, and having less than a high school education.


CONCLUSIONS
Rates of SI among individuals who have sustained a TBI exceed those found among the general population. Increased knowledge of risk factors for SI may assist health care providers in identifying patients who may be vulnerable to SI after TBI.
Jessica L. Mackelprang is with the Harborview Injury Prevention and Research Center, Charles H. Bombardier and Sureyya S. Dikmen are with the Department of Rehabilitation Medicine, Jesse R. Fann is with the Department of Psychiatry and Behavioral Sciences, and Nancy R. Temkin and Jason K. Barber are with the Department of Neurologic Surgery, University of Washington School of Medicine, Seattle.
Jessica L
JL
Mackelprang
Charles H
CH
Bombardier
Jesse R
JR
Fann
Nancy R
NR
Temkin
Jason K
JK
Barber
Sureyya S
SS
Dikmen
D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006304:Health Status; D006801:Humans; D015994:Incidence; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D015995:Prevalence; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology; D059020:Suicidal Ideation; D013997:Time Factors; D014861:Washington / Q000453:epidemiology; D055815:Young Adult