Symptomatic and Functional Recovery Following Concussion in Adolescents With and Without a History of Psychiatric Disorder (P7-1.003)

Abstract

<h3>Objective:</h3> Our study aimed to examine whether symptomatic and functional recovery post-concussion varies between adolescents with and without a history of psychiatric disorder. <h3>Background:</h3> Pre-existing comorbidities can exacerbate impairments following concussion. Psychiatric disorders are associated with emotional symptoms and altered cognition, and similar outcomes are frequently observed post-concussion. Thus, it is possible that a history of psychiatric disorder may be associated with poorer concussion outcomes. <h3>Design/Methods:</h3> We conducted a retrospective analysis of data from a pediatric concussion clinic. Adolescents who had sustained a concussion completed initial (~2 weeks) and follow-up (~5 weeks) post-injury assessments. Assessments included questionnaires regarding concussion symptoms (Rivermead Post-Concussion Symptoms Questionnaire—RPQ), depressive symptoms (Beck Depression Inventory-Youth—BDI), parent-reported executive function (Behavior Rating Inventory of Executive Function—BRIEF), and a modified CogState testing battery. Groups were categorized as adolescents with a parent-reported history of psychiatric disorder (PD+; n = 13) and those reporting no history (PD−; n = 26). <h3>Results:</h3> The PD+ group reported greater severity of RPQ—somatic, RPQ—emotional, and BDI symptoms across time points and had poorer BRIEF—behavioral regulation scores at follow-up (<i>p</i>’s &lt; .05). Compared to PD−, the PD+ group also had greater improvements in accuracy on a two-back working memory task from initial to follow-up evaluations, with higher accuracy at follow-up specifically (<i>p</i>’s &lt; .05). <h3>Conclusions:</h3> Adolescents with a history of psychiatric disorder exhibit more severe concussive and depressive symptoms and poorer behavioral regulation post-concussion than adolescents with no such history. They also display greater increase in working memory accuracy over time; however, this may be attributable to poorer initial performance and a larger subsequent improvement by follow-up. These findings demonstrate a discrepancy between adolescent behavior and parent observations, highlighting the importance of acknowledging psychiatric comorbidities in concussion recovery and incorporating the perspective of both parent and child. <b>Disclosure:</b> Miss Mangold has nothing to disclose. Mr. Kay has nothing to disclose. Dr. Wagner has nothing to disclose. Dr. Holloway has nothing to disclose. Dr. Moore has nothing to disclose.