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Traumatic brain injury and risk of subsequent attempted suicide and violent crime

Published online by Cambridge University Press:  11 April 2022

Katrine M. Ineson Open the ORCID record for Katrine M. Ineson [Opens in a new window] ,
Annette Erlangsen Open the ORCID record for Annette Erlangsen [Opens in a new window] ,
Merete Nordentoft Open the ORCID record for Merete Nordentoft [Opens in a new window] ,
Michael E. Benros  and
Trine Madsen Open the ORCID record for Trine Madsen [Opens in a new window]
Katrine M. Ineson*
Affiliation:
CORE – Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region, Copenhagen, Denmark Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Denmark Department of Clinical Medicine, Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark
Annette Erlangsen
Affiliation:
CORE – Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region, Copenhagen, Denmark Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Denmark Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA Center of Mental Health Research, Australian National University, Canberra, Australia
Merete Nordentoft
Affiliation:
CORE – Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region, Copenhagen, Denmark Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Denmark Department of Clinical Medicine, Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark
Michael E. Benros
Affiliation:
CORE – Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region, Copenhagen, Denmark Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Trine Madsen
Affiliation:
CORE – Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region, Copenhagen, Denmark Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Denmark Department of Public Health, Section of Epidemiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
*
Author for correspondence: Katrine M. Ineson, E-mail: katrine.mohr.christensen@regionh.dk
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Abstract

Background

Traumatic brain injury (TBI) can cause long-lasting sequelae that may increase the risk of suicidal or criminal behaviour, but large-scale longitudinal studies are lacking on the link between TBI and events of suicide attempt and violent crime. This study examined the incidence of suicide attempt and violent crime following hospital contact for TBI in a nationwide cohort study.

Methods

We used nationwide register data covering all individuals aged 10+ living in Denmark during 1980–2016 (n = 7 783 951). Of these, 587 522 individuals had a hospital contact for TBI. Incidence rate ratios (IRR) were calculated by Poisson regression analyses while adjusted for relevant covariates including other fractures and psychiatric diagnoses.

Results

Individuals with TBI had higher rates of suicide attempt (females IRR, 2.78; 95% CI 2.71–2.85; males IRR, 3.00; 95% CI 2.93–3.08) compared to individuals without TBI in adjusted analyses. Multiple TBI and temporal proximity to TBI were associated with higher rates of suicide attempt. Individuals with TBI had higher rates of violent crime (females IRR, 2.43; 95% CI 2.36–2.49; males IRR, 1.80, 95% CI 1.78–1.82) compared with individuals without TBI. Higher rates of violent crime were found after multiple TBI and temporal proximity to TBI.

Conclusions

This nationwide cohort study found higher rates of suicide attempt and violent crime among individuals with prior hospital diagnosed TBI, compared with individuals without TBI. This emphasises the need for preventive efforts immediately after TBI diagnosis, which might mitigate the risks of a trajectory toward suicidal or violent behaviours.

Keywords

epidemiologysuicide attempttraumatic brain injuryviolence
Type
Original Article
Information
Psychological Medicine , Volume 53 , Issue 9 , July 2023 , pp. 4094 - 4102
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Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press

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