{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T10:33:27Z","timestamp":1771065207707,"version":"3.50.1"},"reference-count":38,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Inj Prev"],"accepted":{"date-parts":[[2022,11,21]]},"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Negative outcomes, including suicidal ideation\/attempts, are a major public health concern, particularly among individuals who sustain a traumatic brain injury (TBI). TBI is associated with high rates of postinjury substance use, psychiatric disorders, post-traumatic stress disorder and sleep disturbances. This study examines the mediation effects of substance use, psychiatric disorder and sleep disorder on the associations between TBI and suicidal ideation\/attempts.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A matched case\u2013control study using data from MarketScan databases for private health insurance and Medicaid from October 2015 to December 2018 estimated the association between TBI and suicidal ideation\/attempts using a mediation approach. Individuals less than 65 years of age were included.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In the Medicaid sample, psychiatric disorders mediated 22.4% of the total effect between TBI and suicidal ideation\/attempt, while substance use disorders other than opioid use disorder mediated 7.47%. In the private health insurance sample, psychiatric disorders mediated 3.97% of the total effect, opioid use disorders mediated 2.08% of the total effect and sleep disorder mediated 1.25% of the total effect.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Mediators explained less than 30% of the relationship between TBI and suicidal ideation\/attempt. Findings reinforce the importance of primary prevention of TBI and monitoring patients with a TBI for risk of suicide in the first 6\u201312 months following injury.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/ip-2022-044697","type":"journal-article","created":{"date-parts":[[2022,12,5]],"date-time":"2022-12-05T13:25:45Z","timestamp":1670246745000},"page":"246-252","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Association between traumatic brain injury and suicidality using a mediation approach and MarketScan"],"prefix":"10.1136","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8031-8558","authenticated-orcid":false,"given":"Gabrielle F.","family":"Miller","sequence":"first","affiliation":[{"name":"Division of Injury Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong","family":"Zhou","sequence":"additional","affiliation":[{"name":"Division of Injury Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3033-0177","authenticated-orcid":false,"given":"Alexis B.","family":"Peterson","sequence":"additional","affiliation":[{"name":"Division of Injury Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Swedo","sequence":"additional","affiliation":[{"name":"Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristin","family":"Holland","sequence":"additional","affiliation":[{"name":"Division of Overdose Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcie-jo","family":"Kresnow","sequence":"additional","affiliation":[{"name":"Division of Injury Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,12,5]]},"reference":[{"key":"2025092504390912000_29.3.246.1","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1097\/HTR.0b013e3182225271","article-title":"Suicidal ideation following traumatic brain injury: prevalence rates and correlates in adults living in the community","volume":"26","author":"Tsaousides","year":"2011","journal-title":"J Head Trauma Rehabil"},{"key":"2025092504390912000_29.3.246.2","doi-asserted-by":"crossref","first-page":"229","DOI":"10.5694\/j.1326-5377.2007.tb01206.x","article-title":"Preventing suicide after traumatic brain injury: implications for general practice","volume":"187","author":"Simpson","year":"2007","journal-title":"Med J Aust"},{"key":"2025092504390912000_29.3.246.3","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1002\/jts.22021","article-title":"Traumatic brain injury and suicidal ideation among U.S. operation enduring freedom and operation Iraqi freedom veterans","volume":"28","author":"Gradus","year":"2015","journal-title":"J Trauma Stress"},{"key":"2025092504390912000_29.3.246.4","unstructured":"Taylor C , Jung H . 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