4 Charts | Concussion + Suicide Risk

Risk of Suicide After a Concussion

Figure 1: Risk of Suicide After a Concussion. Having a concussion correlates with twice the risk of suicide compared to those who have not had a concussion. This data was obtained in a meta-analysis of 10 studies. These 10 studies covered a combined 713,706 concussion patients and compared them to 6.2 million matched individuals who did not have a concussion.

The risk of suicide is higher after a concussion. While the difference is small, the evidence is clear.

10 high-quality studies have been conducted so far looking at the link between concussion and suicide. Overall, they have all come to the same conclusion: having a concussion significantly increases your risk of suicide.

Researchers combined data from over 700,000 individuals who had at least one concussion. They compared the risk of suicide to 6.2 million individuals who have not received a concussion as a control group.

They found that overall, among all of the studies combined, individuals who had received a concussion had about twice the risk of committing suicide any given year compared to those who did not receive a concussion.

What is a Concussion?

Concussions are a type of brain injury that happens after a blow or a hit to the head. These can involve a period of unconsciousness, but many concussions do not. Symptoms include headache, confusion, ringing in the ears, nausea, and slurred speech. Individuals may also experience Amnesia, where they forget some events leading up or right after the concussion.

Meta-analysis

Meta-analyses systemically combine data and findings from a selected group of studies on a particular topic to create conclusions with higher statistical significance. These studies do not typically add new data, but rather use data that has already been produced by others. With good methods, they can find more robust and accurate results as they include more data. They can put together conflicting conclusions from smaller studies to create a "final answer."" However, these studies can include bias if inappropriate studies are analyzed. Additionally, they can suffer from publication bias, where only positive results are published and included in the analysis.

Source: Association of Concussion With the Risk of Suicide. A Systematic Review and Meta-analysis

Weekend concussions are riskier

Figure 2: Weekend concussions are riskier. Risk of suicide after concussion varies significantly based on the day of the week of the concussion event. Researchers found that individuals who got a concussion on Saturday or Sunday were at a significantly higher risk of suicide than those who received a concussion on Monday-Friday.

One study found an interesting connection between the day of the week of the concussion and suicide risk.

Individuals who got a concussion on Saturday or Sunday were at a significantly higher risk of suicide compared to those who got a concussion between Monday and Friday.

Source: Risk of suicide after a concussion

Weekend vs Weekday Concussions

Figure 3: Weekend vs Weekday Concussions. Weekend concussions carry a higher risk of suicide compared to weekday concussions. The chart above plots the cumulative risk of suicide per 1000 people based on whether they had a weekend concussion (red), weekday concussion (yellow), or no concussion at all (white). As you can see, all concussions increase the risk of suicide. Weekend concussions carry a significantly higher risk.

Researchers aren’t exactly sure why. One possible reason is that individuals may be more likely to receive different types of concussions on Saturdays and Sundays compared to weekdays. A concussion sustained at work may be more common Monday through Friday, while concussions sustained during recreation and sports may be more common on Saturday and Sunday.

Source: Risk of suicide after a concussion

Risk Factors for Concussion + Suicide

Figure 4: Risk Factors for Concussion + Suicide. Men had over twice the risk of committing suicide after a concussion compared to women. Concussion + Suicide risk is over 5x higher for those who have attempted suicide at least once before. Individuals who had attempted suicide at least once prior had a 5.7x risk of suicide compared to individuals who had never attempted suicide before, among those who have had a concussion.

Two other risk factors include gender and prior suicide attempts. Those who had attempted suicide at least once before had around 5.7 times the risk of suicide compared to those who had not. Similarly, and men had over twice the risk of suicide compared to women after a concussion.

Keys to Health

The mechanisms behind this link is still unclear, as with a lot of the effects of concussion.

What we do know is that the risk of death after concussion can last for many years after the original event due to the elevated risk of suicide.

In terms of absolute numbers, this risk is relatively small. However given the sheer numbers of concussions received every year, this adds up to a substantial burden of suicides.

If you want to stay safe, be sure to wear a helmet. Avoid any situations where you may receive impacts to the head.

While a hard hit to the head may not leave the same scars as a cut to the skin, this data shows that they can leave mental scars that remain for years.

Evidence Score:

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Endpoints - Researchers used suicide as an endpoint, which was an appropriate and objective endpoint for this study.

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Study Size - The study size was large enough to find significant effects and differences between groups.

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Study Type - This study used a meta-analysis, which allows for potentially stronger data by combining findings from multiple small studies.

Expert Opinions

Scientific American

This new study may only represent the tip of the iceberg. “We’re only looking at the most extreme outcomes, at taking your own life,” Redelmeier says. “But for every person who dies from suicide, there are many others who attempt suicide, and hundreds more who think about it and thousands more who suffer from depression.”

Centers for Disease Control

A concussion is a type of traumatic brain injury—or TBI—caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging brain cells.

Harvard School of Public Health

While suicides after concussions are rare, a new analysis has found that patients diagnosed with concussion or mild traumatic brain injury (TBI) had double the risk of suicide when compared with people who did not have brain injuries. The study also found that people with concussion or mild TBI were at increased risk of suicidal thoughts and suicide attempts.

Clearvue Health is not affiliated with above organizations. The information above is provided to highlight and link to useful further reading.