Contributions of posttraumatic stress disorder (PTSD) and mild TBI (mTBI) history to suicidality in the INTRuST consortium.,Brain Injury

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Contributions of posttraumatic stress disorder (PTSD) and mild TBI (mTBI) history to suicidality in the INTRuST consortium.
Brain Injury ( IF 1.9 ) Pub Date : 2020-08-18 , DOI: 10.1080/02699052.2020.1807054
Lauren B Fisher _{1,

2} , Jessica Bomyea _{3,

4} , Garrett Thomas ₂ , Joey C Cheung ₂ , Feng He ₅ , Sonia Jain ₅ , Laura A Flashman ₆ , Norberto Andaluz ₇ , Raul Coimbra ₈ , Mark S George _{9,

10} , Gerald A Grant ₁₁ , Christine E Marx _{12,

13} , Thomas W McAllister _{6,

14} , Lori Shutter ₁₅ , Ariel J Lang _{3,

4,

16} , Murray B Stein _{4,

16} , Ross D Zafonte _{17,

18,

19}

Affiliation

Department of Psychiatry, Harvard Medical School , Boston, Massachusetts, USA.
Department of Psychiatry, Massachusetts General Hospital , Boston, Massachusetts, USA.
VA San Diego Center of Excellence for Stress and Mental Health , San Diego, California, USA.
Department of Psychiatry, University of California San Diego , La Jolla, California, USA.
Biostatistics Research Center, Department of Family Medicine and Public Health, University of California San Diego , La Jolla, California, USA.
Dartmouth-Hitchcock Medical Center, Department of Psychiatry, Dartmouth Geisel School of Medicine at Dartmouth , Hanover, New Hampshire, USA.
Department of Neurological Surgery, University of Louisville , Louisville, Kentucky, USA.
Department of Surgery, Riverside University Health System , Moreno Valley, California, USA.
Psychiatry Division, Ralph H. Johnson VA Medical Center , Charleston, South Carolina, USA.
Department of Psychiatry and Behavioral Sciences, The Medical University of South Carolina , Charleston, South Carolina, USA.
Department of Neurology and Neurosciences, Stanford University Medical Center , Stanford, California, USA.
Durham VA Medical Center , Durham, North Carolina, USA.
Department of Psychiatry and Behavioral Sciences, Duke University , Durham, North Carolina, USA.
Department of Psychiatry, Indiana University School of Medicine , Indianapolis, Indiana, USA.
Department of Critical Care Medicine, Neurology, and Neurosurgery, University of Pittsburgh , Pittsburgh, Pennsylvania, USA.
Department of Family Medicine and Public Health, University of California San Diego , La Jolla, California, USA.
Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Brigham and Women's Hospital, Massachusetts General Hospital, and Harvard Medical School , Boston, Massachusetts, USA.
Massachusetts General Hospital for Children Sports Concussion Program , Boston, Massachusetts, USA.
MGH Red Sox Foundation Home Base Program , Boston, Massachusetts, USA.

Objective

Mild TBI (mTBI) and posttraumatic stress disorder (PTSD) are independent risk factors for suicidal behaviour (SB). Further, co-occurring mTBI and PTSD increase one’s risk for negative health and psychiatric outcomes. However, little research has examined the role of comorbid mTBI and PTSD on suicide risk.

Methods

The present study utilized data from the Injury and TRaUmatic STress (INTRuST) Consortium to examine the prevalence of suicidal ideation (SI) and behaviours among four groups: 1) comorbid mTBI+PTSD, 2) PTSD only, 3) mTBI only, and 4) healthy controls.

Results

Prevalence of lifetime SI, current SI, and lifetime SB for individuals with mTBI+PTSD was 40%, 25%, and 19%, respectively. Prevalence of lifetime SI, current SI, and lifetime SB for individuals with PTSD only was 29%, 11%, and 11%, respectively. Prevalence of lifetime SI, current SI, and lifetime SB for individuals with mTBI only was 14%, 1%, and 2%, respectively. Group comparisons showed that individuals with mTBI alone experienced elevated rates of lifetime SI compared to healthy controls. History of mTBI did not add significantly to risk for suicidal ideation and behaviour beyond what is accounted for by PTSD.

Conclusion

Findings suggest that PTSD seems to be driving risk for suicidal behaviour.

中文翻译：

INTRuST联盟的创伤后应激障碍（PTSD）和轻度TBI（mTBI）历史对自杀的贡献。

目的

轻度TBI（mTBI）和创伤后应激障碍（PTSD）是自杀行为（SB）的独立危险因素。此外，同时发生的mTBI和PTSD会增加人们负面健康和精神病学预后的风险。但是，很少有研究检查合并的mTBI和PTSD在自杀风险中的作用。

方法

本研究利用伤害和创伤压力（INTRuST）联盟的数据来检验自杀意念（SI）的发生率和四组之间的行为：1）合并mTBI + PTSD，2）仅PTSD，3）仅mTBI，和4 ）健康的对照。

结果

mTBI + PTSD患者的生存期SI，当前SI和生存期SB的患病率分别为40％，25％和19％。PTSD患者的一生SI，当前SI和一生SB的患病率分别仅为29％，11％和11％。仅mTBI患者的生存期SI，当前SI和生存期SB的患病率分别为14％，1％和2％。小组比较显示，与健康对照组相比，仅患有mTBI的个体终身SI发生率升高。mTBI的历史并没有显着增加自杀意念和行为的风险，超出了PTSD的范围。