A-56 Post-Concussion Depression Presents in Distinct and Unique Factors

Abstract

Abstract Purpose Post-concussion depression is a commonly endorsed symptom, and a key component of both the Emotional Cluster of the Post-Concussion Symptom Scale and also the Anxiety/Mood Clinical Profile. The purpose of this study was to explore the overlap between the PCSS and items on a widely used measure of depression, the PHQ9, in concussed athletes. Methods A sample of 365 athletes (mean age=15.10±2.25 years; 46% female) seeking care for a concussion at a specialty clinic within 30 days of injury (M= 7.79±7.1 days) were enrolled in the study. The PCSS and PHQ9 were administered to all participants. Two factor analyses were conducted, using: 1) all items from the PCSS and PHQ9, and 2) only the items from the PHQ9. Results The PCSS/PHQ9 FA identified only “Sadness” and “More Emotional” as sharing variance with PHQ9 items, including symptoms of “Feeling Down/Depressed/Hopeless”, “Feeling Bad About Self”, “Suicidal Thoughts” and “Little Interest/Pleasure in Doing Things”. PHQ9 items of “Trouble Concentrating”, “Moving/Speaking Slowly or Fidgety/Restless” and “Feeling Tired/Low Energy” loaded on a unique factor with no shared variance with PCSS items. Factor Analysis of only the PHQ9 items retained all but the “Poor Appetite or Overeating” item, yielding two distinct post-concussion depression factors: a Cognitive/Fatigue Factor and a Depressive/Rumination Factor. Conclusions Post-concussion depression presents as a unique two-factor construct, with some shared variance with PCSS items. Use of an additional measure of depression is recommended to identify post-concussion depressive symptoms beyond “sadness” and “more emotional” and help clinicians determine an appropriate treatment plan.