Skip to main content

Main menu

  • Home
  • COVID-19
    • Articles & podcasts
    • Blog posts
    • Collection
    • News
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • Classified ads
  • Authors
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
  • CMA Members
    • Overview for members
    • Earn CPD Credits
    • Print copies of CMAJ
    • Career Ad Discount
  • Subscribers
    • General information
    • View prices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN

User menu

Search

  • Advanced search
CMAJ
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN
CMAJ

Advanced Search

  • Home
  • COVID-19
    • Articles & podcasts
    • Blog posts
    • Collection
    • News
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • Classified ads
  • Authors
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
  • CMA Members
    • Overview for members
    • Earn CPD Credits
    • Print copies of CMAJ
    • Career Ad Discount
  • Subscribers
    • General information
    • View prices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
  • Visit CMAJ on Facebook
  • Follow CMAJ on Twitter
  • Follow CMAJ on Pinterest
  • Follow CMAJ on Youtube
  • Follow CMAJ on Instagram
Letters

Concussions and suicide

Donald A. Redelmeier, Homer C. Tien and Michael Fralick
CMAJ May 17, 2016 188 (8) 605; DOI: https://doi.org/10.1503/cmaj.1150102
Donald A. Redelmeier
Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Ont.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Homer C. Tien
Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Ont.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Michael Fralick
Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Ont.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Responses
  • Metrics
  • PDF
Loading

Speidel raises some skeptical points about our methods1 because we lack clinical details for the 235 110 patients included in our study.

We agree that more research is justified because concussions can vary in symptoms, severity, context, construal and recovery. We also agree that ascertainment of suicide is challenging, reflects an uncertain number of false-negative results and causes most studies to underestimate the risk of suicide.

Speidel invites us to consider the article by Baron and associates.2 We agree that this study is widely misquoted and appreciate the opportunity to correct several common misunderstandings. First, the study examined cardiovascular mortality and was not powered to investigate self-harm events. Second, the article does not discuss suicide and relegates intentional self-harm to a single line in one table. Third, the overall mortality from all other causes of violent death was distinctly low, as would be expected among wealthy, retired professional athletes. Fourth, the study ended follow-up in 2007 and excluded at least nine former NFL players who committed suicide in the past five years alone (Jovan Belcher, Kurt Crain, Mike Current, Dave Duerson, Ray Easterling, Paul Oliver, Lawrence Phillips, Adrian Robinson and Junior Seau).

The statement from Speidel has one more caveat, since almost half of those included by Baron and associates were African-American men, a group historically that had a low suicide rate during the study enrolment interval (1959–1988). That may explain why the authors never stated that NFL players “experienced concussions at a rate one-sixth that of the general US population.” Otherwise, the authors might imply excess suicide deaths in their sample.

References

  1. ↵
    1. Speidel FX
    . Concussions and suicide [letter}. CMAJ 2016;188:605.
    OpenUrlFREE Full Text
  2. ↵
    1. Baron SL,
    2. Hein MJ,
    3. Lehman E,
    4. et al
    . Body mass index, playing position, race, and the cardiovascular mortality of retired professional football players. Am J Cardiol 2012;109:889–96.
    OpenUrlCrossRefPubMed
PreviousNext
Back to top

In this issue

Canadian Medical Association Journal: 188 (8)
CMAJ
Vol. 188, Issue 8
17 May 2016
  • Table of Contents
  • Index by author

Article tools

Respond to this article
Print
Download PDF
Article Alerts
To sign up for email alerts or to access your current email alerts, enter your email address below:
Email Article

Thank you for your interest in spreading the word on CMAJ.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Concussions and suicide
(Your Name) has sent you a message from CMAJ
(Your Name) thought you would like to see the CMAJ web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Concussions and suicide
Donald A. Redelmeier, Homer C. Tien, Michael Fralick
CMAJ May 2016, 188 (8) 605; DOI: 10.1503/cmaj.1150102

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
‍ Request Permissions
Share
Concussions and suicide
Donald A. Redelmeier, Homer C. Tien, Michael Fralick
CMAJ May 2016, 188 (8) 605; DOI: 10.1503/cmaj.1150102
Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • References
  • Responses
  • Metrics
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Moving surgical care out of hospitals to reduce wait times
  • Coexisting failures do not diminish the stature of a giant
  • Dare we hope
Show more Letters

Similar Articles

Content

  • Current issue
  • Past issues
  • Collections
  • Sections
  • Blog
  • Podcasts
  • Alerts
  • RSS
  • Early releases

Information for

  • Advertisers
  • Authors
  • Reviewers
  • CMA Members
  • Media
  • Reprint requests
  • Subscribers

About

  • General Information
  • Journal staff
  • Editorial Board
  • Governance Council
  • Journal Oversight
  • Careers
  • Contact
  • Copyright and Permissions

Copyright 2021, Joule Inc. or its licensors. All rights reserved. ISSN 1488-2329 (e) 0820-3946 (p)

All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association or its subsidiaries.

Powered by HighWire