Severe Suicidality in Athletes with Chronic Traumatic Encephalopathy: A Case Series and Overview on Putative Ethiopathogenetic Mechanisms

Alessandra Costanza, Michalina Radomska, Francesco Zenga, Andrea Amerio, Andrea Aguglia, Gianluca Serafini, Mario Amore, Isabella Berardelli, Yasutaka Ojio and Khoa D. Nguyen
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Alessandra Costanza: Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), 1211 Geneva, Switzerland
Michalina Radomska: Faculty of Psychology, University of Geneva (UNIGE), 1206 Geneva, Switzerland
Francesco Zenga: Department of Neurosurgery, City of Health and Science Hospital, 10126 Torino, Italy
Andrea Amerio: Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy
Andrea Aguglia: Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy
Gianluca Serafini: Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy
Mario Amore: Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy
Isabella Berardelli: Suicide Prevention Center, Department of Neurosciences, Mental Health and Sensory Organs, Sant’Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy
Yasutaka Ojio: National Center of Neurology and Psychiatry, Department of Community Mental Health Law, National Institute of Mental Health, Tokyo 187-8553, Japan
Khoa D. Nguyen: Department of Microbiology and Immunology, Stanford University, Palo Alto, CA 94304, USA

IJERPH, 2021, vol. 18, issue 3, 1-15

Abstract: Chronic traumatic encephalopathy (CTE) results from repetitive brain injuries and is a common neurotraumatic sequela in contact sports. CTE is often accompanied by neuropsychiatric symptoms, which could escalate to suicidal ideation (SI) and suicidal behaviour (SB). Nevertheless, fairly limited emphasis about the association between suicidality and CTE exists in medical literature. Here, we report two cases of retired professional athletes in high contact sports (boxing and ice hockey) who have developed similar clinical trajectories characterized by progressive neuropsychiatric symptoms compatible with a CTE diagnosis and subsequent SB in its severe forms (medical serious suicide attempt (SA) and completed suicide). In addition to the description of outlining clinical, neuropsychological, neuroimaging, and differential diagnosis elements related to these cases, we also hypothesized some mechanisms that might augment the suicide risk in CTE. They include those related to neurobiological (neuroanatomic/neuroinflammatory) dysfunctions as well as those pertaining to psychiatry and psychosocial maladaptation to neurotraumas and retirement from professional competitive activity. Findings described here can provide clinical pictures to improve the identification of patients with CTE and also potential mechanistic insights to refine the knowledge of eventual severe SB development, which might enable its earlier prevention.

Keywords: chronic traumatic encephalopathy; contact sports; neuropsychiatric symptoms; suicide; suicidal ideation; suicide attempt; suicidal behaviour (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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