Chronic traumatic encephalopathy and suicide: a systematic review

Area of Science:

• Neuroscience
• Public Health
• Pathology

Background:

• Traumatic brain injury (TBI) is a significant global health issue.
• Emerging evidence suggests a single mild TBI can lead to chronic traumatic encephalopathy (CTE).
• Concerns exist regarding a potential link between CTE and suicide, with critical implications for prevention and policy.

Purpose of the Study:

• To systematically review the existing medical literature.
• To assess the evidence supporting a relationship between CTE and suicide.

Main Methods:

• Systematic literature searches were conducted for CTE and suicide.
• Seven articles were selected for full-text review.
• Two case series, comprising 17 unique cases (5 suicides), met inclusion criteria.

Main Results:

• The reviewed studies lacked blinding, control cases, and systematic data collection on TBI exposure or medical history.
• The literature on CTE exhibited heterogeneity in neuropathological findings and clinical presentations.
• The overall quality of evidence for a CTE-suicide relationship was rated as very low (GRADE criteria).

Conclusions:

• The current evidence base for a relationship between CTE and suicide is very limited and of low quality.
• Further high-quality research with rigorous methodology is required.
• The existence and nature of any association between CTE and suicide remain undetermined.