Identifying group-based patterns of suicidal ideation over the first 10 years after moderate-to-severe TBI

Objective To identify group-based patterns in suicidal ideation (SI) over the first 10 years after traumatic brain injury (TBI). Methods Participants included 9539 individuals in the TBI Model Systems National Database who responded to Patient Health Questionnaire-9 Item 9 assessing SI at 1, 2, 5, and/or 10 years post-injury. A k-means cluster analysis was conducted to determine group-based patterns of SI, and pre-injury variables were compared with ANOVAs and chi-square tests. Results SI and attempts decreased over time. Four group-based patterns emerged: Low, increasing, moderate, and decreasing SI. The low SI group comprised 89% of the sample, had the highest pre-injury employment, fewer mental health vulnerabilities, least severe injuries, and were oldest. The increasing SI group had the most severe TBIs, were youngest, and disproportionately Black or Asian/Pacific Islander. Conclusion These findings reinforce the importance of mental health and suicide risk assessment during chronic recovery from TBI.