Several studies have suggested that, following a traumatic brain injury (TBI), the risk of developing major depressive disorder is elevated, as compared with that of the general population. Several smaller, isolated studies have suggested an increased risk of suicide as well. This study used the TBI Model Systems database (TBIMS) to better understand the rates of depression, suicidal ideation, suicide attempts and completed suicides among patients with moderate to severe TBI, who have undergone inpatient rehabilitation.
METHODSData were collected from October of 2007 through September of 2013, including that of patients, ages 16-99, who completed the Patient Health Questionnaire (PHQ-9) assessment of depression at one or more assessment points. Suicidal ideation was assessed from the PHQ-9. Suicide attempts and completed suicide acts were also documented.
RESULTSOf the 12，046 individuals enrolled, 21 completed suicides were recorded with a cumulative rate of 0.17%. The rate of suicide at years 1, 2, 2-5, 5-10, 10-15, and 15-20, was recorded at 0.03%, 0.05%, 0.06%, 0.02%, 0.02% and 0.0% respectively. During the 20 years of follow-up, rates of depression ranged from 25% to 28%, with 4.3% reporting one prior suicide attempt. Throughout the study, rates of suicidal ideation were two to three times higher than in the general population.
CONCLUSIONThis study of patients with moderate to severe traumatic brain injury, who received inpatient rehabilitation, found higher rates of depression and suicidal ideation than in the general population.