Commotion related to the risk of suicide

MONDAY, November 12, 2018 (HealthDay News) – People who have had either a concussion or mild brain trauma are twice as likely to commit suicide as others, according to a new study.

The badysis also indicates that men and women who have suffered a concussion are also more likely to consider suicide or try to commit suicide.

The investigators pointed out that the absolute risk of suicide for any patient with a concussion remains very low.

Nevertheless, Dr. Michael Fralick, lead author of the study, was somewhat surprised that many of the 17 studies reviewed indicated "that concussion was clearly a risk factor for suicide, attempted suicide and suicidal thinking. ".

Regarding what can or should be done to solve the problem, Fralick replied, "It takes more research."

"I think it's also important that people know effective strategies to prevent concussions," he added. "For example, common sense advising to avoid contact sports, especially at a young age, is fine, but as a proud Canadian who grew up playing hockey and rugby, I appreciate Not everyone will follow this advice, and for those who practice these sports, wearing a helmet and a mouthguard is very important to reduce the risk of concussion. "

Fralick is a general internist at the University of Toronto.

Concussions are the most common type of traumatic brain injury, with 4 million per year in the United States.

For four of the five patients who suffered a concussion, all neurological symptoms disappeared within a week. But about a quarter of patients will continue to struggle with chronic mental health issues, such as anxiety and depression.

The studies reviewed were conducted between 1963 and 2017 and involved more than 700,000 patients with a history of concussion or mild traumatic brain injury. Another 6.2 million patients who have never suffered one or the other of injuries also participated.

Four studies highlighted the very low absolute risk of suicide among participants. Four to 12 years after a traumatic brain injury, screen for the risk of suicide between 0.28% and 0.59%.

But the risk seemed to double in patients diagnosed with at least one concussion or mild traumatic brain injury.

Fralick explained that too few studies were sufficient to say whether multiple concussions – a common phenomenon among football players – could further increase this risk.

Investigators have proposed several theories as to why a concussion or mild brain injury could increase the risk of suicide. Among them: abnormal brain activity after the accident, especially abnormal communication in brain regions that control thought and emotions. The brain tests showed both.

Another possibility: accidents can also lead to a progressive neurodegenerative disease, said the research team.

Whatever the case may be, people must take special precautions after a concussion, Fralick said.

"For anyone with a concussion, it is extremely important that they rest after the event and avoid drinking alcohol," he said. "We know that as soon as someone has a concussion, his brain is very vulnerable to another concussion."

Dr. Donald Redelmeier, Principal Investigator at the Sunnybrook Research Institute in Toronto, wrote an editorial that accompanied the study. He said the findings were consistent with what he had seen in practice.

"A concussion can sometimes cause lasting damage that results in a gradual loss of a person's life," he said, adding that it could lead to a life of considerable suffering and emotional instability. even if patients with TBI do not commit suicide.

Either way, Redelmeier said the findings should encourage psychiatrists to take into account trauma history when badessing a patient's suicide risk and to help raise awareness in the community. They also stress the need to prevent such injuries, he added.

The results were published November 12 in the journal JAMA Neurology.

More information

Learn more about concussions at the National Institutes of Health of the United States.