Examining Suicidality in Adolescents Who Have Sustained Concussions

Previous studies have reported an association between concussion and suicidality in high school students in the United States. When controlling for multiple life stressors in adolescence (e.g., bullying, substance use, poor grades), however, the relationship between concussion and suicidality was either attenuated or became non-significant in one study. Rather than assessing concussion as a possible risk factor for suicidality, this study examined predictors of ideation, planning, and attempts among youth who experienced concussion in the past year. The sample included 13,677 participants from the 2019 Youth Behavior Risk Survey, of whom 1754 (13%) reported experiencing a concussion in the past year. Binary logistic regressions were conducted to predict ideation, planning, and attempts with modifiable stress factors, including physical activity, bullying, poor grades, insufficient sleep, binge drinking, marijuana use, illicit drug use, and depression. Among adolescents who experienced a concussion in the past year, 25% reported suicidal ideation (31% girls/19% boys), 20% reported suicide planning (25% girls/17% boys), and 15% reported a suicide attempt (17% girls/13% boys). In a multi-variable model among girls with prior year concussion, being bullied (odds ratio [OR] = 2.37), illicit drug use (OR = 2.80), current marijuana use (OR = 2.47), and depression (OR = 9.22) predicted suicidal ideation. Among boys with prior year concussion, being bullied (OR = 2.29) and depression (OR = 9.50) predicted suicidal ideation. Additional models were used to examine the association between having one or more modifiable stressors and suicidality, revealing that having three or more modifiable stressors was associated with a substantial increase in proportions of youth reporting suicidality. Among adolescents experiencing a concussion, treating depression and substance use, stopping bullying, and increasing physical activity may be associated with reduced risk for suicidality.