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Sexual dilemmas associated with double suicide risk

(Reuters Health) – The number of survivors of traumatic brain injury is likely to be more than twice as likely to die as a suicide, as individuals with no injuries, such as shocks or fractures in the skull, suggest a survey.

Conclusions are derived from six studies involving a total of over 700,000 people who experienced shock or other traumatic brain injury and more than 6.2 million people without this diagnosis. Half of the participants studied in studies from two to twelve years or more.

The absolute risk of suicide was low. It was found that less than 1 percent of people died during the studies.

"The starting point is that 99 percent of people who are shocked will not have a suicide-related outcome," said lead author Dr. Michael Fralick from the University of Toronto, Canada.

"There are very few people in suicidal ideation, suicide attempt or suicide risk," Fralick said via email. "For anyone with suicidal thoughts, it is extremely important that they seek urgent medical attention."

Although in recent years, professional athletes and military personnel have in recent years been well known suicide bombers after shocks and injuries to brain injuries, researchers have no clear idea of ​​the link between these injuries and suicide, Fralick and colleagues note JAMA Neurology.

About 80 percent of people with shocks, neurological symptoms disappear during the week, study authors note. However, in some patients, neurological symptoms, including anxiety and depression, may last for several years.

Researchers note that severe brain injuries have long been associated with prolonged risk of neurological symptoms and suicide.

However, shocks and light brain injuries are more common, and less common is the direct relationship between these events and suicide.

The current analysis focused on shocks and mild traumatic brain injury and revealed that these events are associated with an increased risk of suicidal thoughts and suicide attempts in addition to suicide-related deaths.

Although the exact reason for this connection is unclear, shocks and mild traumatic brain injuries may cause long-term changes in the brain regions associated with mood regulation and decision making, the researchers note.

Smaller analytical studies did not control the experiments that were designed to prove that brain injury could directly lead to suicide. These small studies also differed, and it is possible that long-term data might be needed to get a clearer picture of the long-term effects of brain trauma on mental health.

However, the results indicate the need to eliminate the turmoil and the long-term effects of physical and mental health after brain injury, said Dr. Donald Redelmeier, author of the accompanying editorial board.

"This study emphasizes that everyday people need to eliminate more brain shocks, such as belts, using helmets and avoiding reckless tricks," said Redelmeier, e-mail from Toronto University and Sunnybrook Hospital.

"In addition, the study disputed popular stereotypes of masculinity leading to head injuries and encouraged psychiatrists to be regarded as a history of past trauma in assessing the risk of suicide in a patient," added Redelmeier. "Suicide is preventable."

SOURCE: JAMA Neurology, Online, November 12, 2018.

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