Model System:


Reference Type:


Accession No.:



Archives of Physical Medicine and Rehabilitation

Year, Volume, Issue, Page(s):

, 97, 8, 1301-1308

Publication Website:


Study examined whether severity of head and extracranial injuries (ECI) is associated with suicidal ideation (SI) or suicide attempt (SA) after traumatic brain injury (TBI). Factors associated with SI and SA were assessed using data collected 1, 2, and 5 years post-TBI from 3,575 participants from 15 TBI Model System centers, linked with outcomes from the National Trauma Data Bank. SI was measured via the Patient Health Questionnaire 9 (question 9). SA in the last year was assessed via interview. ECI was measured by the Injury Severity Scale and categorized as none, mild, moderate, or severe. Results indicated that there were 293 (8.2 percent) participants who had SI without SA and 109 (3.0 percent) who had SA at least once in the first 5 years after injury. Random effects logit modeling showed a higher likelihood of SI when ECI was severe. Drug use at time of injury was also associated with SI. Severity of ECI was not associated with SA. This study showed that severe ECI carried a nearly 3-fold increase in the odds of SI after TBI, but it was not related to SA. Head injury severity and less severe ECI were not associated with SI or SA. These findings warrant additional work to identify factors associated with severe ECI that make individuals more susceptible to SI after TBI.


Kesinger, Matthew R., Juengst, Shannon B., Bertisch, Hillary, Niemeier, Janet P., Krellman, Jason W., Pugh, Mary Jo, Kumar, Raj G., Sperry, Jason L., Arenth, Patricia M., Fann, Jesse R., Wagner, Amy K.