Risk Factors for Suicidal Ideation Following Mild Traumatic Brain Injury: A TRACK-TBI Study.

The analysis sample varied from 727 to 883 because of attrition or missing data, so not all 1158 enrolled patients contributed to every model. The PHQ-9 item 9 asked about the past 2 weeks, but visits were separated by longer intervals, so some suicidal thoughts may have been missed. Suicidal thoughts were measured with a single item, which is generally less reliable than a multi-item measure. Psychiatric history, prior TBI, and suicidal thoughts were self-reported, so patients may have remembered or reported them differently. The study did not assess preinjury suicidal thoughts, so it cannot tell whether postinjury thoughts were new or continuing. Exclusions such as debilitating mental disorders or mandated psychiatric hold may have removed some high-risk patients. It included only patients seen in emergency departments and evaluated with head CT at level 1 trauma centers, so results may not apply to people with mild TBI who are not evaluated this way. The study could not separate post-TBI symptoms from depression because they were strongly correlated and the symptom association became nonsignificant after depression adjustment. It did not test treatments, so it cannot say whether reducing symptoms or depression lowers suicide risk. The outcome was suicidal thoughts, not suicide attempts or death.

The supplied text says the other authors declare no conflicts of interest. The article metadata lists NIH and other government research support, but no sponsor role is described.

Do not conclude that mild TBI causes suicidal thoughts or suicide attempts. The study was observational, suicidal thoughts were measured with one PHQ-9 item, and the authors state that most people who think about suicide do not attempt or die by suicide.