Brent Masel, M.D., medical director of the Brain Injury Association of America, authored a paper entitled “Brain Injury as a Chronic Disease” in which he presented the strong argument that traumatic brain injury should be thought of as a chronic disease. In the white paper he laid out the long term consequences of TBI, including increased mortality and the increased incidence of sequelae from TBI. Nevertheless, defense courtroom doctors continue to argue that mild traumatic injury is self limiting and does not result in long term problems.

A new study from the University of Toronto, titled “Risk of Suicide after a Concussion,” assessed the long-term risk of suicide after concussion. Dr. Michael Fralick and his colleagues performed a longitudinal cohort analysis of adults with the diagnosis of a concussion in Ontario, Canada from April 1, 1992 to March 31, 2012, a 20 year period. Severe cases that resulted in hospitalization were excluded.

The researchers identified 235, 110 patients who had sustained a concussion during this time period. The mean age was 41 years, 52% were men, and most (86%) lived in an urban location. A total of 667 subsequent suicides occurred in this group over a median follow-up of 9.3 years, equivalent to 31 deaths per 100,000 patients annually or 3 times the population norm. Weekend concussions were associated with 1/3 further increased risk of suicide compared with weekday concussions.

The researchers concluded, “Adults with a diagnosis of concussion had an increased risk of suicide, particularly after concussions on weekends. Greater attentions to the long term care of patients after concussions in a community might save lives because deaths from suicide can be prevented.”

For more information, please listen to this interview with the authors of the study. You can also find more about it in an article published by Scientific American.