Abstract
Concussions are among the most common neurological conditions, with emergency departments and sports injury clinics seeing hundreds of patients each year. The consideration of risk factors such as age, sex, and comorbid conditions are very important when looking at individual physiological and psychological outcomes after a concussion. The purpose of this study was to look at four comorbid conditions (depression, anxiety, behavioural disorder, or learning disability) and identify any interactions with age and sex in symptom presentation after suffering a concussion. A total of 4,865 participants from the CCMI (Complete Concussion Management Inc.) dataset were used with 1,577 self-identified with a diagnosis of anxiety, depression, a behavioural disorder, or a learning disability. Fixed-factor analyses of variance were used with age and sex as fixed, grouping factors and symptom total and severity as dependent measures. For the individuals who did not have one of the 4 mental health conditions (3,288 control participants), symptom total and symptom severity increased with age (p < 0.05), and females showed more symptoms and a higher symptom severity than males across all ages (p < 0.05). A diagnosis of anxiety or depression exacerbated total symptoms and symptom severity from 25–50% above control levels in the 19 and under age groups, while depression or anxiety exacerbated total symptoms and severity by 10–15% in males more than females over 20. A diagnosis of a behavioural disorder or a learning disability exacerbated symptom severity by approximately 50% above control levels in 13–19–year-old females and in males of 30 years and older. This study highlights how the presence of a mental health condition may alter concussion symptom presentation dependent on age and sex. The identification of risk factors and how they may interact can be of great value to health care providers who manage concussion symptoms and recovery.
Highlights
Mild traumatic brain injuries are among the most common neurological conditions, affecting millions of people each year [1]
A concussion is often described as a subset of Mild traumatic brain injuries (mTBI), whereby there are rapid changes in neurological function that are short-lived and resolve spontaneously [2,3,4]
The current study examined the comorbid conditions of anxiety, depression, behavioural disorders, and learning disabilities and how they interact with age and sex to contribute to total symptoms and symptom severity after suffering a concussion
Summary
Mild traumatic brain injuries (mTBI) are among the most common neurological conditions, affecting millions of people each year [1]. Loss of consciousness may occur, but it is seen in less than 5–10% of patients who suffer a concussion [7]. Prolonged loss of consciousness indicates a more severe brain injury [5]. Symptoms may not surface until days or weeks following the injury and can even be missed or misdiagnosed at first because the individual may appear to be fine. The underreporting of concussions and concussion-like symptoms continues to be a serious medical concern, especially with athletes [8]. Those who continue to participate in sports after
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