A - 18 Parent-Ratings of Patient Depressive Symptoms Are Predictive of Concussion Care Outcomes in a Pediatric Sample

Abstract

Abstract Objective The present study aims to examine how parental perception and child self-perception of depressive symptoms influence key clinical outcomes post-concussion, including symptom burden, treatment time, and treatment retention. Methods Participants 10–18 years (14.3 ± 2.2, 44.3% female, 3.8% history of depression) were recruited from a specialty clinic within 30 days of concussion (n = 106). The Mood and Feelings Questionnaire-Short (MFQ) Parent and Child versions and the Post-concussion Symptom Scale (PCSS) were completed at initial (Time 1) and second (Time 2) visits. Scores ≥8 indicate clinically significant depression on the MFQ, producing child-rated depression (CRD) and parent-rated depression (PRD) scores. Time in treatment was calculated as days between initial and clearance visits. Results Results of linear regression demonstrated higher PRD predicted longer treatment, B = 0.21, t(103) = 2.07, p < 0.05. CRD was not predictive of treatment time, B = -0.0, t(103) = −0.1, p = 0.99. Another regression using Time 2 PCSS score as the outcome demonstrated that CRD at Time 1 predicted PCSS score at Time 2, B = 0.29, t(94) = 2.85, p < 0.01, while PRD did not, B = 0.14, t(94) = 1.41, p = 0.16. Results of a logistic regression predicting return for formal clearance indicated that higher PRD predicted increased likelihood of being lost to follow-up, B = 0.21, p < 0.05, 95% CI = 1.05–1.44. Conclusions Patients whose parents perceived them as being more depressed were in treatment longer and were less likely to be formally cleared after concussion. However, child rated depression at initial visit was more useful in predicting concussion symptom burden at follow up. Future research should further investigate how parental perceptions may influence pediatric concussion recovery.