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Prior Injury and Motor Vehicle Crash as Risk Factors for Youth Suicide

Grossman David C.; Soderberg, Robert; Rivara, Frederick P.
Epidemiology: March 1993

We conducted a case-control study to determine whether adolescents and young adults who have been in a motor vehicle crash or hospitalized for unintentional and intentional injury are at greater risk for suicide. Cases were 700 Washington State residents age 16–35 with a driver's license who died of suicide during 1987–1989. Controls were 3,494 licensed drivers matched by age, sex, and zip code. Using two different databases, we were able to determine the past incidence of in-state injury hospitalizations and motor vehicle crashes for all subjects. Overall, the incidence of suicide was tenfold higher among those with a past hospitalization for injury. Many of these admissions were for suicide attempts [odds ratio (OR) = 56, 95% confidence interval (CI) = 27–120], but the risk of suicide was also higher among those hospitalized for unintentional injuries (OR = 5.0, 95% CI = 2.2–11.5) and assaults (OR = 4.5, 95% CI.= 1.1–18). The relative risk for suicide was 2.7 (95% CI = 2.0–3.5) for those with prior injury as a driver in a motor vehicle crash and 2.9 (95% CI = 2.2–3.8) for those with involvement in a single vehicle crash. Many unintentional injury hospitalizations and a proportion of motor vehicle crashes in younger adults may represent unrecognized suicide attempts.

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