An assessment, “Association of Concussion With the Risk of Suicide,” was published online in JAMA, of studies involving more than 7 million individuals has found an association between concussions, mild TBI, and risk of suicide. Investigators found there to be a more than two-fold greater risk of suicide in people to be diagnosed with at least 1 concussion and/or mild TBI compared to those not diagnosed with either (RR= 2.03 [95% CI: 1.47 – 2.80] P < .001). A majority of studies also reported a heightened risk of suicide attempt following a concussion and/or mild TBI. In separate, stratified analyses comparing military personnel to civilian populations, investigators reported a higher combined estimate for studies of nonmilitary populations (RR 2.36 [95% CI: 1.64 – 3.40] P < .01) than the combined estimate for studies of military populations (RR 1.46 [95% CI: 0.80 – 2.58] P < .01).
Researchers emphasized the high prevalence of both concussions, which occur approximately 4 million times in the US annually—with up to 25% of patients experiencing chronic neuropsychiatric symptoms including anxiety and depression for years after injury. “Evaluating the potential association between concussion and/or mild TBI and suicide is important, because concussion and mild TBI are common, affect individuals of every age, and are often preventable,” Fralick and colleagues wrote. “Furthermore, even if the absolute risk of suicide is low, evidence of an association between concussion and mild TBI and suicide across a range of populations is important because of the seriousness of the outcome.”