Suicide is the leading cause of death in Australian males and females aged between 15 – 44 years. There are many factors that increase a person’s risk of suicide including having a history of mental health issues like depression and anxiety, making a previous suicide attempt, substance abuse problems, family history of suicide or a family history of abuse.

In the US, suicide is also the leading cause of death in the military.  Suicide in the community is typically related to a mental health issue whereas in the military it is sometimes linked to a combat related concussion.

Depressive episodes are thought to be high in people who’ve been concussed however whether this increases people’s risk of suicide outside the military context is not well known.

Researchers investigated whether concussion incurred on a weekday or weekend was associated with an increased long-term risk of suicide in Canadian adults.

The research group compared concussions occurring on weekdays with those occurring on weekends as they hypothesised that the severity and mechanism of injury, as well as the type of care received, might differ during different times of the week.

Nearly a quarter of a million people had a diagnosis of concussion over the two decades of the study. The primary outcome was suicide. A total of 667 suicides occurred in the study population over an average 9-year follow-up.

The long-term risk of suicide in those with concussion was three times that of the population norm and higher for concussions occurring on a weekend compared to a weekday. The increased risk was independent of past mental health conditions.

The highest risk factor associated with suicide was a previous suicide attempt.

Implications

The results of this research suggest that concussion may be a risk factor for suicide however more research is needed to confirm this association. Other research has suggested that concussion can cause lasting changes in brain function, mood or behaviour, particularly in people such as athletes in contact sports who sustain multiple concussions over their career.

Concussions are largely preventable through adequate training, use of protective gear, safety measures and avoidance of alcohol and risk taking behaviour.

This study, as in others, identified previous suicide attempts as the predominant long-term risk factor for suicide. Extra and considered assistance should be provided to people who’ve attempted suicide to ensure that it does not happen again.

If you or anyone close to is having suicidal thoughts speak to a professional or phone Lifeline on 13 11 14 for free and confidential crisis support.

Last Reviewed: 14/09/2019

© Norman Swan Medical Communications.



References

Fralick, M et al. Risk of suicide after a concussion. CMAJ 2016. DOI: 10.1503/cmaj.150790