Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Feb;22(1):66-86.
doi: 10.36131/cnfioritieditore20250106.

The Relationship Between Traumatic Brain Injury and Suicide: A Systematic Review of Risk Factors

Rosaria De Luca  1 , Andrea Calderone  2 , Maria Grazia Maggio  1 , Antonio Gangemi  1 , Francesco Corallo  1 , Gianluca Pandolfo  3 , Carmela Mento  3 , Maria Rosaria Anna Muscatello  3 , Mirjam Bonanno  1 , Angelo Quartarone  1 , Rocco Salvatore Calabrò  1
Affiliations

The Relationship Between Traumatic Brain Injury and Suicide: A Systematic Review of Risk Factors

Rosaria De Luca et al. Clin Neuropsychiatry. 2025 Feb.

Abstract

Objective: Traumatic brain injury (TBI) significantly increases the risk of suicidal ideation (SI) and behaviors due to neurobiological changes, cognitive impairments, and emotional dysregulation. This review consolidates current evidence on the relationship between TBI and suicide, identifying key risk factors and underlying mechanisms, and highlights the need for further research, especially in civilian populations.

Method: Studies were identified from an online search of PubMed, Web of Science, Cochrane Library, Embase, and Scopus databases with studies published from 2014 to 2024. This review has been registered on Prospero (number CRD42024574643).

Results: Factors indicated such as external causes of injury, comorbidities like depression and substance use disorders, and post-TBI symptoms consistently influence suicide risk. Advanced predictive models emphasize the role of psychological symptoms, particularly depressive features, in forecasting SI post-TBI, underscoring the need for targeted interventions and early symptom management.

Conclusions: The seriousness of TBI significantly impacts the probability of SI and suicide attempts (SA). Research consistently shows that patients with more severe TBIs tend to have higher rates of SI and SA. Psychological disorders, such as depression and substance abuse disorders, greatly increase the likelihood of suicidal actions after a TBI. These conditions not only raise the occurrence of SI but also lead to earlier and more regular SA.

Keywords: TBI; neurorehabilitation; suicidal risk.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None.

Figures

Figure 1.
Figure 1.
Cognitive, emotional, biological, and structural aspects linked to suicide risk among TBI
Figure 2.
Figure 2.
PRISMA 2020 flow diagram of evaluated studies
See this image and copyright information in PMC

References

    1. Aaronson, A. L., Smith, B., Krese, K., Barnhart, M., Adamson, M., de Wit, H., Philip, N. S., Brenner, L. A., Bender-Pape, T., & Herrold, A. A. (2024). Impulsivity and Psychiatric Diagnoses as Mediators of Suicidal Ideation and Suicide Attempts Among Veterans With Traumatic Brain Injury. The Journal of Neuropsychiatry and Clinical Neurosciences, 36(2), 125– 133. 10.1176/appi.neuropsych.20230044 - DOI - PMC - PubMed
    1. Ahmed, S., Venigalla, H., Mekala, H. M., Dar, S., Hassan, M., & Ayub, S. (2017). Traumatic Brain Injury and Neuropsychiatric Complications. Indian Journal of Psychological Medicine, 39(2), 114–121. 10.4103/0253-7176.203129 - DOI - PMC - PubMed
    1. An Evaluation of Crisis Hotline Outcomes Part 2: Suicidal Callers—Gould—2007—Suicide and Life-Threatening Behavior—Wiley Online Library. (s.d.). Recuperato 6 settembre 2024, da https://onlinelibrary.wiley.com/doi/10.1521/suli.2007.37.3.338 - DOI - PubMed
    1. Awan, N., DiSanto, D., Juengst, S. B., Kumar, R. G., Bertisch, H., Niemeier, J., Fann, J. R., Kesinger, M. R., Sperry, J., & Wagner, A. K. (2021). Evaluating the Cross-Sectional and Longitudinal Relationships Predicting Suicidal Ideation Following Traumatic Brain Injury. The Journal of Head Trauma Rehabilitation, 36(1), E18–E29. 10.1097/HTR.0000000000000588 - DOI - PMC - PubMed
    1. Bahraini, N., Adams, R. S., Caban, J., Kinney, A. R., Forster, J. E., Hofmire, C. A., Monteith, L. L., & Brenner, L. A. (2023). Racial and Ethnic Diferences in Deaths by Suicide, Drug Overdose, and Opioid-Related Overdose in a National Sample of Military Members With Mild Traumatic Brain Injury, 1999-2019. The Journal of Head Trauma Rehabilitation, 38(2), 114. 10.1097/HTR.0000000000000829 - DOI - PMC - PubMed

LinkOut - more resources