Association between Traumatic Brain Injury and Suicidality using a Mediation approach and MarketScan

Details

• Alternative Title:
  Inj Prev
• Personal Author:
  Miller, Gabrielle F. ; Zhou, Hong ; Peterson, Alexis B. ; Swedo, Elizabeth ; Holland, Kristin ; Kresnow, Marcie-jo
• Description:
  Introduction:
  
  Negative outcomes, including suicidal ideation/attempts, are a major public health concern, particularly among individuals who sustain a traumatic brain injury (TBI). TBI is associated with high rates of post-injury substance use, psychiatric disorders, post-traumatic stress disorder, and sleep disturbances. This study examines the mediation effects of substance use, psychiatric disorder, and sleep disorder on the associations between TBI and suicidal ideation/attempts.
  
  Methods:
  
  A matched case control study using data from MarketScan databases for private health insurance and Medicaid from October 2015 to December 2018 estimated the association between TBI and suicidal ideation/attempts using a mediation approach. Individuals less than 65 years of age were included.
  
  Results:
  
  In the Medicaid sample, psychiatric disorders mediated 22.2% of the total effect between TBI and suicidal ideation/attempt, while substance use disorders other than opioid use disorder mediated 7.46%. In the private health insurance sample, psychiatric disorders mediated 4.18% of the total effect, opioid use disorders mediated 2.17% of the total effect, and sleep disorder mediated 1.25% of the total effect.
  
  Conclusions:
  
  Mediators explained less than 30% of the relationship between TBI and suicidal ideation/attempt. Findings reinforce the importance of primary prevention of TBI and monitoring patients with a TBI for risk of suicide in the first 6-12 months following injury.
  
  
• Subjects:
  Brain Injuries, Traumatic Case-Control Studies Humans Risk Factors Sleep Wake Disorders Substance-Related Disorders Suicidal Ideation Suicide Suicide, Attempted
• Keywords:
  Mediation Opioid Use Psychiatric Disorder Sleep Disorder Substance Use TBI
• Source:
  Inj Prev.
• Pubmed ID:
  36600521
• Pubmed Central ID:
  PMC10198876
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:6efb4d82b5fb68032adce239523750f10e083e6927632602e0f59ce592f7e900
• Download URL:
  https://stacks.cdc.gov/view/cdc/128676/cdc_128676_DS1.pdf
• File Type:
  [PDF - 234.62 KB ]