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. 2023 Jun;29(3):246-252.
doi: 10.1136/ip-2022-044697. Epub 2022 Dec 5.

Association between traumatic brain injury and suicidality using a mediation approach and MarketScan

Gabrielle F Miller  1 , Hong Zhou  2 , Alexis B Peterson  2 , Elizabeth Swedo  3 , Kristin Holland  4 , Marcie-Jo Kresnow  2
Affiliations

Association between traumatic brain injury and suicidality using a mediation approach and MarketScan

Gabrielle F Miller et al. Inj Prev. 2023 Jun.

Abstract

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 postinjury 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 22.4% of the total effect between TBI and suicidal ideation/attempt, while substance use disorders other than opioid use disorder mediated 7.47%. In the private health insurance sample, psychiatric disorders mediated 3.97% of the total effect, opioid use disorders mediated 2.08% 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.

Keywords: Case-Control Study; Psychological; Traumatic Brain Injury.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1:
Figure 1:
Concept model of mediation relationship
See this image and copyright information in PMC

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