Concussion patients ages 5-24 experience increased (but still low) suicide risk
By John Rosseel. This article was initially published in the 10/23/25 edition of our Concussion Update newsletter; please consider subscribing.
An article in the American Journal of Preventive Medicine found that the risk of suicide in patients ages 5-24 increased after sustaining a concussion. Yang et al. used Ohio Medicaid claims from 41,341 concussion patients and 376,171 orthopedic injury (OI) patients who were monitored for up to ten years. The OI group was used as a control to monitor suicide rates and to account for potential bias in experiencing injury. Using death certificates, the team correlated participants’ injuries with a possible death by suicide. They found that 42 people died by suicide in the concussion patients group compared to the 229 in the OI group. Due to the differing sizes of the groups, this meant the concussion group had a suicide risk of around .084% compared with the OI group’s .050%, or a 60% increased risk of dying by suicide compared to controls with orthopedic injury.
Further, each subsequent concussion after the first was associated with a roughly 50% increased risk of suicide. These results persisted even when the researchers accounted for biases inherent in race, sex, age, and mental health. While these increased risks are considerable, the total suicide risk 5 years post-concussion was .034% higher than in the OI group, which would equate to 34 more people dying by suicide per 100,000 people with concussions. As the article notes, though “overall risk remains low” for those who have sustained concussions, targeted prevention strategies are crucial to protect those with increased susceptibility to suicide after their injury. Yang et al. suggest “early screening for suicide risk and mental health concerns, as well as integrated, collaborative care models to support recovery and reduce long-term risk– particularly for youth with repeated concussions”.
Yang et al. argue that, while the mechanisms connecting concussions and suicide are elusive, concussions can impact brain function (such as serotonin and dopamine production), which may lead to an increased risk of depression and anxiety. Concussions can also impair neurochemistry, metabolism, and cognition; impairments to cognition that may lead to poor judgment and decision-making, which, in developing brains, may raise susceptibility to suicidal thoughts. These factors, combined with increased isolation from school and sports due to recovery, contribute to the risk of suicide, anxiety, and depression. The team highlights that a pervasive misunderstanding of concussions is to blame for inaccurate rehabilitation and reporting. They argue that caregivers may assume concussions go away quickly and won’t impact life after recovery. Instead, Yang et al. state, “These findings support the view of TBI as a chronic health condition with long-term consequences…”
This article, while strengthened by its large and diverse concussion and control groups, has key limitations. Data was collected from a single state, Ohio, and a single insurance provider, Medicaid, which may introduce social biases that may not be present in other samples. Furthermore, patients in the concussion group were not diagnosed with a standardized assessment. Rather, the diagnostic criteria and assessment procedures were at the discretion of the doctor who saw each patient. In turn, the specific clinical data surrounding diagnoses were unavailable– apart from the diagnosis itself. Further research is necessary to better understand the connection between concussion and suicidality in children and young adults.