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Study links concussion with increased long-term suicide risk

A recent study found an increased long-term risk of suicide in people who have had a concussion. This risk was even higher in people who were diagnosed with a concussion on a weekend.

Concussions are traumatic brain injuries that are usually caused by a blow to the head. Concussion symptoms are usually temporary.

Canadian researchers at the University of Toronto and the Institute of Clinical Evaluative Sciences used medical records to identify 235,111 patients in Ontario who were diagnosed with a concussion over a 20-year period (1992-2012). All the patients were 18 or over, with an average age of 41, and about half were men. Most lived in urban areas.

There were 667 suicides in this group over a median followup time of just over nine years. The researchers calculated that this represents a suicide rate which is triple the rate seen in the general population. The average time between concussion and suicide was just under six years.

Of the 667 suicides, 519 were in patients whose concussion occurred on a weekday, and 148 were in patients who got a concussion during the week. Weekday and weekend concussions tend to have different causes which may suggest different severity, as well as more subtle differences. Workplace and occupational injuries are more likely on weekdays, and recreational and sports injuries more likely on weekends.

When weekday and weekend concussions were compared, the long-term suicide risk associated with weekend concussions was even higher: four times the rate seen in the general population. Even when compared to weekday concussion patients, those who had a concussion on weekends had a 27 per cent increase in long-term suicide risk.

Concussions do not show on medical images, and their symptoms usually resolve. However, according to background information provided in the study, some research has suggested that concussion can cause lasting changes in brain physiology, mood or behaviour.

Other predictors of long-term suicide risk identified in the study were previous suicide attempts, history of psychiatric illness, being male, and having low socioeconomic status. These are consistent with what is known about suicide risks. However, the increased risk associated with concussion was still present in patients who had none of the known psychiatric risk factors.

The study authors, led by Dr. Donald Redelmeier, point out some key differences between concussion history and other risk factors for suicide. They note that concussion may be preventable in some cases. Also, for mental health purposes, concussion may not be viewed as a red flag in a patient’s medical history.

The study was published in CMAJ on Feb. 8, 2016.

 

 

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  • A publication of:
  • Women's College Hospital