Subclinical, long-term psychological symptoms following sport-related concussion: are athletes more depressed than we think?

• Published in: Brain injury 2024-07, Vol.38 (8), p.637-644
• Main Authors: Burns, Carter, Jo, Jacob, Williams, Kristen, Davis, Phil, Amedy, Amad, Anesi, Trevor J, Prosak, Olivia L, Rigney, Grant H, Terry, Douglas P, Zuckerman, Scott L
• Format: Article
• Language: English
• Subjects: Adolescent; Athletes - psychology; Athletic Injuries - complications; Athletic Injuries - psychology; Brain Concussion - complications; Brain Concussion - psychology; Child; Cohort Studies; Depression - etiology; Depression - psychology; Female; Humans; Male; Young Adult
• ISSN: 0269-9052; 1362-301X
• DOI: 10.1080/02699052.2024.2334352

In adolescent and collegiate athletes with sport-related concussion (SRC), we sought to evaluate the prevalence and predictors of long-term psychological symptoms. A cohort study was conducted of athletes 12-24-year-old diagnosed with SRC between November 2017 and April 2022. Athletes/proxies were interviewed on psychological symptoms (i.e. anger, anxiety, depression, and stress). Participants who scored ≥75th percentile on one or more PROMIS (Patient-Reported Outcomes Measurement System) measures were operationalized to have subclinical, long-term psychological symptoms. Uni/multivariable regressions were used. Of 96 participants (60.4% male), the average age was 16.6 ± 2.6 years. The median time from concussion to interview was 286 days (IQR: 247-420). A total of 36.5% athletes demonstrated subclinical, long-term psychological symptoms. Univariate logistic regression revealed significant predictors of these symptoms: history of psychiatric disorder (OR = 7.42 95% CI 1.37,40.09), substance use (OR = 4.65 95% CI 1.15,18.81), new medical diagnosis since concussion (OR = 3.43 95% CI 1.27,9.26), amnesia (OR = 3.42 95% CI 1.02,11.41), other orthopedic injuries since concussion (OR = 3.11 95% CI 1.18,8.21), age (OR = 1.24 95% CI 1.03,1.48), days to return-to-play (OR = 1.02 95% CI 1.00,1.03), and psychiatric medication use (OR = 0.19 95% CI 0.05,0.74). Multivariable model revealed significant predictors: orthopedic injuries (OR = 5.17 95% CI 1.12,24.00) and return-to-play (OR = 1.02 95% CI 1.00,1.04). Approximately one in three athletes endorsed long-term psychological symptoms. Predictors of these symptoms included orthopedic injuries and delayed RTP.