Increased Risks of Suicide Attempt and Suicidal Drug Overdose Following Admission for Head Injury in Patients with Depression

Dorji Harnod, Tomor Harnod, Cheng-Li Lin, Wei-Chih Shen and Chia-Hung Kao
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Dorji Harnod: Department of Emergency and Critical Care Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City 243, Taiwan
Tomor Harnod: Department of Neurosurgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan
Cheng-Li Lin: Management Office for Health Data, China Medical University Hospital, Taichung 404, Taiwan
Wei-Chih Shen: Department of Computer Science and Information Engineering, Asia University, Taichung 413, Taiwan
Chia-Hung Kao: Graduate Institute of Biomedical Sciences and School of Medicine, College of Medicine, China Medical University, Taichung 404, Taiwan

IJERPH, 2019, vol. 16, issue 19, 1-12

Abstract: Aims: To determine the risks of suicide attempt (SA) and suicidal drug overdose (SDO) following the admission for head injury of patients with depression. Design: We analyzed the NHIRD data of patients aged ≥20 years who had received depression diagnoses between 2000 and 2010. They were divided into cohorts of those with admission for head injury (DHI) and those without it (DWI) during the follow-up period and compared against a sex-, age-, comorbidity-, and index-date-matched cohort from the general population. Setting: The Taiwan National Health Insurance Research Database (NHIRD). Participants/Cases: We analyzed the NHIRD data of patients (≥20 years) who had received depression diagnoses between 2000 and 2010. Intervention(s): Regular interventions. Measurements: We calculated the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) of SA and SDO in these cohorts after adjustment for age, sex, and comorbidities. Findings: Up to the end of 2011, our results revealed extremely high incidences of SA and SDO with 63.3 and 88.6 per 10,000 person-years, respectively, in the DHI cohort. The DHI cohort had a 37.4-times higher risk for SA and a 17.1-times higher risk for SDO compared with the comparison group and had aHRs of 14.4 and 16.3, respectively, for poisoning by medicinal substances and poisoning by tranquilizers compared with patients in the DWI cohort. Patients with DHI aged <50 years, of female sex, with high incomes, living in more urbanized areas, and without other comorbidities had extraordinarily higher risks for SA. Conclusions: The risks of SA and SDO were proportionally increased by head injury in patients with depression in Taiwan. Our findings provide crucial information to implement efficient suicide prevention strategies in the future.

Keywords: cohort study; depression; suicide; head injury; National Health Insurance (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
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