Context: Depression is common after concussion and is associated with functional outcome and quality of life after injury. However, few baseline predictors of postconcussion depressive symptoms (PCDS) have been found.Objective: To describe the prevalence of depressive symptoms in a collegiate athlete sample at baseline and postconcussion, compare these levels of symptoms and change in symptoms with those of a control group with no reported concussions in the past year, and examine the baseline predictors for PCDS.Design: Case-control study. Main Outcome Measure(s): The Beck Depression Inventory-Fast Screen was administered to the concussion group at baseline and postconcussion and to the control group at 2 time points.Results: Seventeen athletes (20%) showed a reliable increase in depression, and more athletes reported clinically important depression postconcussion than at baseline. Only 2 participants (5%) in the control group showed a reliable increase in depression. Concussed athletes were more likely to show a reliable increase in depression symptoms than control participants (v 2 1 ¼ 5.2, P ¼ .02). We also found several predictors of PCDS in the athletes, including baseline depression symptoms (r ¼ 0.37, P , .001), baseline postconcussion symptoms (r ¼ 0.25, P ¼ .03), estimated premorbid intelligence (full-scale IQ; r ¼ À0.29, P ¼ .009), and age of first participation in organized sport (r ¼ 0.34, P ¼ .002). For the control group, predictors of depression symptoms at time 2 were number of previous head injuries (r ¼ 0.31, P ¼ .05) and baseline depression symptoms (r ¼ 0.80, P , .001).Conclusions: A large proportion of athletes showed a reliable increase in depression after concussion, and we identified several baseline predictors. Given that depression affects quality of life and recovery from concussion, more research is necessary to better understand why certain athletes show an increase in PCDS and how these can be better predicted and prevented.Key Words: concussion, depressive symptoms, sports
Key PointsThe prevalence of clinically important depression symptoms was higher postconcussion than at baseline. Postconcussion depression symptoms were related to a higher level of baseline depression symptoms and baseline postconcussion symptoms, lower estimated full-scale IQ, older age at first participation in organized sport, and fewer number of games missed due to concussion. Nonwhite ethnicity was associated with increased postconcussion depression symptoms. More research is needed to better predict which athletes might have more severe depression symptoms postconcussion.