Study finds association between concussions and increased risk of suicidal behavior in U.S. high school students

By Melissa Brown. This article was initially published in our Concussion Update newsletter; please consider subscribing.

U.S. high school students self-reporting ≥2 sports- and recreation-associated concussions (SRRCs) were significantly more likely to report suicidal attempts, according to a year-long retrospective cross-sectional study published in the Journal of Athletic Training. Diving deeper, gender differences impacted the association between the frequency of SRRCs (no concussions, one concussion, or two or more concussions) and suicidal behavior. 

Girls and boys reporting a single SRRC experienced significantly greater odds of suicidal behavior, with the primary gender difference being that boys behavior did not include planning–they acted more impulsively–while girls’ behavior included suicidal planning. The strength of the association between an SRRC and suicidal behavior remained equal from one SRRC to multiple SRRC in females but increased in males. Particularly, males who experienced two or more SRRCs in the past 12 months had double the rate of reported attempted suicide compared to males with a single SRRC.

The researchers recommend that “health care professionals should closely monitor mental health behaviors in adolescents with repetitive concussions, especially those that occur in close temporal proximity.”

While robust in performance and clearly presented, this study has limitations. Self-report studies rely on the accuracy of participants. Further, while the researchers measured suicidal behavior and number of concussions in the past 12 months, the researchers were not able to infer a “causal relation between concussion and adolescent suicidality.” In addition, due to the limitations of the database used, this study only investigated non-fatal suicide behaviors.