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Risk of suicide after a concussion
Michael Fralick1, Deva Thiruchelvam1, Homer C Tien1
1Department of Medicine (Fralick, Redelmeier), University of Toronto; Evaluative Clinical Sciences (Fralick, Thiruchelvam, Tien, Redelmeier), Sunnybrook Research Institute; Institute for Clinical Evaluative Sciences (Thiruchelvam); Canadian Forces Health Services (Tien), Toronto, Ont.
Summary
Adults with a concussion face a higher long-term suicide risk. Weekend concussions show a significantly increased risk compared to weekday injuries, highlighting the need for better post-concussion care.
Area of Science:
- Neuroscience
- Public Health
- Epidemiology
Background:
- Head injuries, including concussions, are linked to suicide risk in military personnel.
- The long-term suicide risk following community-acquired concussions remains unclear.
Purpose of the Study:
- To assess the long-term risk of suicide after concussions in the general population.
- To compare suicide risk between weekend and weekday concussions.
Main Methods:
- Longitudinal cohort analysis of adults diagnosed with concussion in Ontario, Canada (1992-2012).
- Exclusion of severe concussion cases requiring hospital admission.
- Primary outcome: long-term suicide risk following weekend vs. weekday concussion.
Main Results:
- 235,110 patients with concussion identified; 667 subsequent suicides over 9.3 years median follow-up.
- Suicide rate was 31 per 100,000 patients annually, 3x the population norm.
- Weekend concussions showed a 36% increased suicide risk (RR 1.36) compared to weekday concussions, independent of demographics and prior psychiatric conditions.
Conclusions:
- Individuals diagnosed with concussion have an elevated long-term suicide risk.
- Concussions sustained on weekends are associated with a particularly higher risk of suicide.
- Enhanced long-term care for concussion patients in the community may prevent suicides.