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Suicidal Ideation Following Traumatic Brain Injury: Prevalence Rates and Correlates in Adults Living in the Community

Tsaousides, Theodore PhD; Cantor, Joshua B. PhD; Gordon, Wayne A. PhD

The Journal of Head Trauma Rehabilitation: July/August 2011 - Volume 26 - Issue 4 - p 265–275
doi: 10.1097/HTR.0b013e3182225271
Original Articles

Objective: To explore the rates of suicidal ideation (SI) in a sample of community-dwelling adults with traumatic brain injury (TBI) and to assess the relationship between SI and demographic and injury characteristics, pre- and postinjury psychiatric history, and psychosocial functioning.

Participants: Data were collected from a cohort study focused on health, psychosocial functioning, and community integration post-TBI (N = 356). Participants were individuals with mild to severe TBI living in the community.

Measures: The Beck Depression Inventory II (BDI-II) was used to assess SI. Psychiatric functioning was assessed using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) (DSM-IV) Axis I disorders (SCID-I), and psychosocial functioning was assessed using the Life-3, the Flanagan Scale of Unmet Needs, and the Bigelow Quality of Life Questionnaire.

Results: There were no differences in SI endorsement based on gender, age, race, income, education, injury severity, or length of time since injury. Those who met current criteria for a psychiatric diagnosis of depression, anxiety, or posttraumatic stress disorder reported SI more frequently. Those with SI reported significantly lower psychosocial functioning.

Conclusion: Individuals with TBI from all demographic groups and with injuries of varying severity are at risk for SI and thus for emotional distress and suicidal behavior. Screening for SI is indicated in all individuals with TBI, particularly those with a history of premorbid substance misuse and concurrent mood and anxiety disorders. The importance of interventions to maximize social support and reduce social isolation is discussed.

Department of Rehabilitation Medicine, Mount Sinai School of Medicine, New York.

Corresponding Author: Theodore Tsaousides, PhD, Department of Rehabilitation Medicine Mount Sinai School of Medicine, One Gustave L. Levy Place New York, NY 10029 (

This project was funded by grants H133P050004, H133B040033, and H133A070033 from the National Institute on Disability and Rehabilitation Research, US Department of Education and grant 1R49CE001171-01 from the Centers for Disease Control and Prevention. The authors would like to extend their gratitude to Lisa Spielman, who aided in the design and analysis and to Vladimira Varbanova for her contribution in the preparation of the manuscript.

© 2011 Lippincott Williams & Wilkins, Inc.