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New Risk After TBI – Suicide

September 17, 2018



Before we get into the article, today is National Physician Suicide Awareness Day. Watch the video. Learn how to help. And if you’re the one who needs help, please tell someone. We are in this together. Let’s not lose one more person among us to suicide.

Learn more about what you can do to help.

You need to see this YouTube video on preventing suicide among medical trainees.


Written by Clay Smith

Spoon Feed
The incidence of suicide nearly doubled in patients who had traumatic brain injury (TBI) compared to baseline.  Risk increased with severity of injury, number of visits, and was highest in the first 6 months post-injury.

Why does this matter?
We often counsel families on what to expect after TBI/concussion: headache, nausea, vertigo, or emotional ups and downs.  But I don’t usually mention suicide.  Looks like I probably should.

An unexpected peril after TBI
This was a large national Danish registry that found nearly doubled incidence of suicide among those with TBI (41/100,000 person-years vs 20).  The more severe, the greater the risk.  Also, the more times the patient had medical contact, the greater the risk.  Risk was greatest in the first 6 months after TBI but persisted out to 7 years.  This information changes the way I will counsel patients.  I need to start warning patients to get help if they feel unexplained depression or suicidal thoughts and to ask family members to watch out for this after TBI.  It also needs to heighten concern when patients present with depression or suicidal ideation after sustaining TBI.

Association Between Traumatic Brain Injury and Risk of Suicide.  JAMA. 2018 Aug 14;320(6):580-588. doi: 10.1001/jama.2018.10211.
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Another Spoonful
This is an excellent resource for Healthcare Professional Burnout, Depression, and Suicide Prevention.

Reviewed by Thomas Davis

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