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Brain Injury Volume 34, 2020 - Issue 10
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Research Article

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

Lauren B. Fishera Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA;b Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USACorrespondence[email protected]
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Jessica Bomyeac VA San Diego Center of Excellence for Stress and Mental Health, San Diego, California, USA;d Department of Psychiatry, University of California San Diego, La Jolla, California, USAORCID Iconhttps://orcid.org/0000-0001-9853-135XView further author information
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Garrett Thomasb Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USAView further author information
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Joey C. Cheungb Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USAView further author information
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Feng Hee Biostatistics Research Center, Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, USAView further author information
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Sonia Jaine Biostatistics Research Center, Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, USAView further author information
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Laura A. Flashmanf Dartmouth-Hitchcock Medical Center, Department of Psychiatry, Dartmouth Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USAView further author information
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Norberto Andaluzg Department of Neurological Surgery, University of Louisville, Louisville, Kentucky, USAView further author information
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Raul Coimbrah Department of Surgery, Riverside University Health System, Moreno Valley, California, USAView further author information
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Mark S. Georgei Psychiatry Division, Ralph H. Johnson VA Medical Center, Charleston, South Carolina, USA;j Department of Psychiatry and Behavioral Sciences, The Medical University of South Carolina, Charleston, South Carolina, USAView further author information
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Gerald A. Grantk Department of Neurology and Neurosciences, Stanford University Medical Center, Stanford, California, USAView further author information
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Christine E. Marxl Durham VA Medical Center, Durham, North Carolina, USA;m Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USAView further author information
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Thomas W. McAllisterf Dartmouth-Hitchcock Medical Center, Department of Psychiatry, Dartmouth Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA;n Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USAView further author information
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Lori Shuttero Department of Critical Care Medicine, Neurology, and Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USAView further author information
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Ariel J. Langc VA San Diego Center of Excellence for Stress and Mental Health, San Diego, California, USA;d Department of Psychiatry, University of California San Diego, La Jolla, California, USA;p Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, USAView further author information
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Murray B. Steind Department of Psychiatry, University of California San Diego, La Jolla, California, USA;p Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, USAView further author information
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Ross D. Zafonteq Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Brigham and Women’s Hospital, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts, USA;r Massachusetts General Hospital for Children Sports Concussion Program, Boston, Massachusetts, USA;s MGH Red Sox Foundation Home Base Program, Boston, Massachusetts, USAView further author information
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Pages 1339-1349 | Received 10 Jan 2020, Accepted 31 Jul 2020, Published online: 18 Aug 2020
 
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ABSTRACT

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.

Acknowledgments

Data were collected for this study under a grant from the US. Army Medical Research and Material Command (USAMRMC), USAMRMC. Funding Mechanism: Contract #W81XWH-08-2-0159 (Stein et al.), DOD INTRuST.

Declarations of interest

The authors report no conflicts of interest.

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website.

Additional information

Funding

This work was supported by the Medical Research and Materiel Command [Contract #W81XWH-08-2-0159 (Stein et al.), DOD INT].

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