B-65 Systematic Review of Pre-Injury Mental Health Problems as a Vulnerability Factor for Worse Outcome Following Sport-Related Concussion

Abstract

Abstract Objective A systematic review of the extent to which pre-injury mental health problems are a vulnerability factor for slower clinical recovery from sport-related concussion, defined as recovery from symptoms or a return to normal activities, including school and sports, following injury. Data Selection We conducted a search using (i) concussion-related terms, (ii) sport/athlete-related terms, and (iii) diverse predictor/modifier terms in the following databases: PubMed, PsycINFO®, MEDLINE®, CINAHL, Cochrane Library, EMBASE, SPORTDiscus, Scopus, and Web of Science. Studies published by February 2019 that examined pre-injury mental health problems as a possible predictor of clinical recovery from concussion were included. A total of 4,013 articles were screened. A full-text review was conducted on 358 articles, and 12 articles were ultimately included. Data Synthesis Those with a preinjury history of mental health problems were at greater risk for having persistent symptoms. There are major methodological differences across the studies. Most of the articles were not focused on mental health as a primary predictor, and the sample sizes in most studies were small. The type of preinjury mental health problems were inconsistently defined. The age of onset, course, severity, and duration of mental health problems were not defined. The extent to which the mental health problems were present prior to the season, during baseline testing, was not reported. Conclusions Pre-injury mental health difficulties predict prolonged recovery from concussion, but much more research is needed to understand the mechanisms and the magnitude of the effect.