Impact of suicidality on delayed-onset post-traumatic stress disorder is modified by age : A two-year longitudinal study

Objectives
This study aimed to investigate the relationship between early suicidality and post-traumatic stress disorder (PTSD) onset in patients with physical injuries, focusing on age as a modifying factor.

Methods
At baseline, 1014 patients were evaluated for suicidality, age divided into younger (<60 years) vs. older (≥60 years) groups, and potential covariates. PTSD was diagnosed at follow-up at 3, 6, 12, and 24 months, and then were categorized into early-onset (within the first six months after trauma) and delayed-onset (more than six months after trauma). Logistic regression models were used after adjusting for covariates.

Results
Presence of suicidality at baseline was significantly associated with delayed-onset PTSD in older but not younger patients with significant interaction terms, whereas it was significantly associated with early-onset PTSD across all age groups.

Conclusion
Age-specific associations were found between suicidality and PTSD onset. The findings highlight the importance of early suicidality assessment, especially in older patients for ongoing monitoring and support, and underscore the critical need for early PTSD identification and intervention for all ages.

Highlights

• Prospective associations of suicidality with both early- and delayed onset PTSD after; physical injuries were evaluated.
• Potential modifying effect of age on the associations was investigated.
• Suicidality was linked to early-onset PTSD in patients across all age groups.
• Suicidality was significantly associated with delayed-onset PTSD in older but not in younger group.
• Patients' age and suicidality should be considered for predicting delayed-onset PTSD.