title: The association between traumatic brain injury and suicide: are kids at risk?
abstract: Traumatic brain injury (TBI) in late adolescence and adulthood is associated with a higher risk of suicide; however, it is unknown whether this association is also present in people who sustained a TBI during childhood. The purpose of the present study was to determine whether experiencing a TBI during childhood is a risk factor for suicide later in life and to examine whether the risk of suicide differs by sex or injury severity. A cohort of 135,703 children aged 0-17 years was identified from the Quebec population-based physician reimbursement database in 1987, and follow-up was conducted until 2008. Of the children in this cohort, 21,047 had sustained a TBI. Using a survival analysis with time-dependent indicators of TBI, we found a higher risk of suicide for people who sustained a TBI during childhood (hazard ratio (HR) = 1.49, 95% confidence interval (CI): 1.04, 2.14), adolescence (HR = 1.57, 95% CI: 1.09, 2.26), and adulthood (HR = 2.53, 95% CI: 1.79, 3.59). When compared with less severe injuries, such as concussions and cranial fractures, more severe injuries, such as intracranial hemorrhages, were associated with a higher risk of suicide (HR = 2.18 vs. 2.77, respectively). Repeated injuries were associated with higher risks of suicide in all age groups.
authors.forename: Yvonne F
authors.initials: YF
authors.lastname: Richard
authors.forename: Bonnie R
authors.initials: BR
authors.lastname: Swaine
authors.forename: Marie-Pierre
authors.initials: MP
authors.lastname: Sylvestre
authors.forename: Alain
authors.initials: A
authors.lastname: Lesage
authors.forename: Xun
authors.initials: X
authors.lastname: Zhang
authors.forename: Debbie Ehrmann
authors.initials: DE
authors.lastname: Feldman
mesh_terms: D000293:Adolescent; D001930:Brain Injuries / Q000453:epidemiology*; D002170:Canada / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D018570:Risk Assessment; D013405:Suicide / Q000706:statistics & numerical data*
keywords: adults; childhood; mental health; pediatrics; repeated injuries; suicide; traumatic brain injury; youth