Postconcussion Depressive Symptoms and Clinical Assessment Associations in Adolescents

Abstract

Between 1.1 and 1.9 million sport-related concussions occur annually in the United States in those younger than 18 yr (1). Concussion is defined as a mild traumatic brain injury induced by biochemical forces (2). Increases in somatic (headache, nausea, dizziness, balance impairment) and affective (mood disturbance, depression, anxiety, irritability, fatigue) symptoms as well as declines in cognitive function and sleep quality are common after concussion (2,3).An estimated 13% of adolescents aged 12 to 17 yr in the United States experienced at least one major depressive episode in 2017 (4). The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) defines a depressive disorder as a common, yet serious medical illness that causes feelings of sadness and/or a loss of interest in activities once enjoyed (5). In addition, depression can lead to a variety of emotional and physical problems that decrease a person's ability to function at work, home, and in social situations. Diagnostic criteria include a depressed mood or loss of interest or pleasure in daily activities for more than 2 wk, which represents a change from the person's usual behavior (4). Depressed individuals experience difficulty concentrating and sleeping, decreased energy, and loss of interest in activities or hobbies (4).Concussion and depression are connected through overlapping symptoms including the inability to focus, excessive drowsiness, emotional irritability, fatigue, anxiety, sadness, and sleep disturbances (3,5). Furthermore, research has established a positive correlation between concussion history and depression diagnosis (6) as well as increased depressive symptoms after concussion (7,8). When looking at the connection between depression and concussion recovery, previous literature has found that depression is a risk factor for prolonged recovery from concussion (9,10) and that depressive symptoms after concussion are associated with postconcussive symptoms (11). However,

Perceived Stress, Mindfulness, and Clinical Concussion Outcomes in Adults with a Concussion History

“…VOMS symptom change scores were calculated by summing all symptom ratings pretest and posttest for each VOMS assessment, and for each VOMS assessment, subtracting the total symptom score at baseline from the posttest score. Change scores that were negative (i.e., when the participant reported higher/worse symptoms at baseline compared with the posttest) were coded as zero to indicate no provocation of symptoms (46,48). The outcome for the VOMS assessment was each symptom change score (46,48).…”

“…Change scores that were negative (i.e., when the participant reported higher/worse symptoms at baseline compared with the posttest) were coded as zero to indicate no provocation of symptoms (46,48). The outcome for the VOMS assessment was each symptom change score (46,48).…”