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3.9 Examining acute concussion symptom reporting in adolescent student athletes with a pre-injury history of mental health problems
  1. Charles Gaudet1,2,3,
  2. Katie Stephenson4,
  3. Nathan Cook1,2,3,
  4. Paul Berkner4,
  5. Grant Iverson1,2,3
  1. 1Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, USA
  2. 2MasGeneral Hospital for Children Sports Concussion Program, Waltham, USA
  3. 3Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, USA
  4. 4College of Osteopathic Medicine, University of New England, Biddeford, USA

Abstract

Objective Pre-injury mental health problems are associated with worse clinical outcome following sport-related concussion. Greater acute symptoms, measured in the first 72 hours post injury, are also a risk factor for longer recovery. This study examines symptom reporting in acutely injured student athletes stratified by pre-injury mental health problems.

Design Cross-sectional, observational study.

Setting Adolescent student athletes from schools in Maine, USA.

Participants Pre-season baseline and post-injury data were available for 879 athletes 0–3 days following injury. Adolescents were divided into two groups: (i) no psychiatric history and (ii) self-reported history of treatment for a psychiatric disorder (n=75, 8.5%).

Assessment of Risk Factors Demographic information, health history, and pre-injury symptoms.

Outcome Measures Post-Concussion Symptom Scale (PCSS) total score and factor scores.

Main Results During preseason baseline testing, youth with a history of treatment for a psychiatric disorder endorsed a significantly greater severity of affective (Cohen’s d=0.38), cognitive (d=0.34), physical (d=0.35), and sleep-arousal (d=0.31) symptoms compared to those with no mental health history. Both groups showed a very large increase in symptom reporting following concussion for the physical (d=2.07–2.25), cognitive (d=1.99–1.69), and sleep-arousal (d=1.11–1.13) factors—and a medium increase on the affective factor for the group with no pre-injury psychiatric history (d=0.49). There was no statistically significant increase on the affective factor following concussion for the youth with a pre-injury psychiatric history.

Conclusions These results are a first step in the direction of developing more personalized precision rehabilitation for youth with a pre-injury history of mental health problems.

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