Medical Journal of Australia | 2019
Concussion risk and suicide prevention: balancing the risks and benefits of youth sport
Abstract
Recent population data have identified that young Australians are now more likely to take their own life than die in a motor vehicle accident.1 Suicide accounts for over onethird of deaths (36%) among 15–24yearold Australians.1 The need to understand the neurobiological mechanisms underpinning suicidality in youth, as well as potential strategies that can be implemented to address these, is of great importance. Consequent to the dramatic hormonal, neurological and psychosocial changes that typically occur during adolescence, adolescents present a unique population within which to explore the potential neurophysiological and biological mechanisms of suicidality. It is well known that the prefrontal cortex and hippocampal regions undergo substantial development during adolescence (Box, A).2 Within the complex networks of interconnected brain regions (Box, C), the hippocampus and the prefrontal cortex stand out as particularly relevant to understanding the neurobiological mechanisms underpinning depression and suicidality in youth. Abnormality or dysfunction in these areas contributes to behavioural disinhibition, poor problem solving, impaired decision making and emotional instability, all of which are risk factors for suicidal behaviour.3 While the milieu of clinical youth suicide prevention strategies continues to develop, it is important to consider the promotion of youth engagement with activities that may protect against depression and suicide from a fundamental biological level, outside of clinical settings.