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Concussion, TBI, and Suicide Risk: Separating the Research from the Media Hype

May 20, 2014

Last month, major news outlets reported that a new study had linked concussions to a higher suicide risk among adolescents—but did the media get the story right?

In April, headlines such as “Concussions make young people more likely to attempt suicide” (U.S. News and World Report) and “Once-concussed teenagers found to be at higher risk for bullying, suicide” (Education Week) began to appear. Each source referenced a study by Dr. Gabriela Ilie, a post-doctoral fellow at St. Michael’s Hospital in Toronto. Ilie’s study, which was published on April 15 in the science journal Plos One, looked at data from 4,685 surveys administered to adolescents in grades 7 through 12 as part of a 2011 drug use and health survey in Ontario.

In the weeks since, however, there has been some criticism, not of the study itself but of the way it was covered by the media. In her April 22 article “The press release that fell and hit its head,” Brenda Goodman, a health writer for the Association of Healthcare Journalists, followed up with Ilie about the study. One of Goodman’s criticisms is that the media coverage—including St. Michael’s own press release—used the word “concussion” to describe the brain injuries that were associated with suicide risk, even though the study itself does not use that word. Instead, the study refers to a narrower band of more traumatic brain injuries, defined as “head injury that resulted in being unconscious for at least 5 minutes or being retained in the hospital for at least one night.”

Why is that distinction so important? Goodman points out that more serious brain injuries are likely to be the result of car accidents or assaults; sports-related concussions, while still serious, result in loss of consciousness only about 10 percent of the time.

So what did the study actually say about TBI and suicide risk? “When holding constant sex, grade, and complex sample design,” according to Ilie’s findings, “students with TBI had significantly greater odds of reporting elevated psychological distress (AOR = 1.52), attempting suicide (AOR = 3.39), seeking counselling through a crisis help-line (AOR = 2.10), and being prescribed medication for anxiety, depression, or both (AOR = 2.45).” The study goes on to say that students with TBI had higher odds of being bullied or threatened with a weapon at school, compared with students who did not report a TBI. Ilie recommends that physicians screen for potential mental health and behavioral problems in adolescent patients with TBI.

This study demonstrated a correlation between some types of TBI and suicide risk in adolescents; it did not, however, show a causal relationship between concussion and suicide. Brenda Goodman and health writers like her remind us that when it comes to psychology news, it’s important to go beyond the headlines and look at the original research.