Traumatic brain injury and suicide risk

A. Nardella 1, G. Falcone 1, A. Padovano 1, L. Bonanni 1, D. Erbuto 1, D. Lester 2, M. Pompili 1

1 Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, Rome, Italy; 2 The Richard Stockton University, NJ, USA

Among the various consequences of traumatic brain injury (TBI), evidence supports the notion that individuals exposed to such events may be at higher risk of suicide. We therefore aim at reviewing the literature by focusing on possible association between TBI and features of the suicidal spectrum, such as suicidal ideation, suicide attempts and completed suicides. We carried out a computerized search for reports of studies involving TBI and suicide risk. A total of 35 reports provide data with preliminary support of this association. Seven articles showed a direct correlation between TBI and completed suicides. Thirteen articles have shown a direct relationship between TBI and suicide attempts; five articles demonstrated a positive correlation with suicidal ideation and suicidality. We also found negative results failing to show a correlation between TBI and completed suicides (one article), suicide attempts (one article) and suicidality (one article). In addition, one article showed that patients who received psychological treatment (CBT therapy) after suffering a head injury showed a significant reduction in suicidal ideation.

These preliminary findings encourage further testing of the association between TBI and suicide risk regardless of the psychiatric history. Furthermore, those who have a history of psychiatric illness before the TBI present a greater risk of suicide than those who do not have psychiatric precedents.

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