Presentation Type
Oral Presentation
Abstract/Artist Statement
Context: Athletes who sustain an injury may experience depression, anxiety, tension, fear, and low self-esteem due to being taken out of their sport and changing their daily activities. These acute and chronic emotional or mood disturbances are common and highly studied in concussion patients; however, acute consequences of concussions are not as well understood. This review will seek to clarify the understanding of acute mood disturbances and depressive symptoms post-concussion in a physically active population based on the current available literature. This will provide information for healthcare providers to use in athletes’ return to play decisions and follow-up care post-concussion. This information also allows better understanding and education available to athletes, parents, coaches, teachers, school administrators, and many other people who play integral roles in athletes’ healing after a concussion. Methods: A systematic literature search was completed in October 2019 via the PubMed database to include articles published between 2004 and 2019. The search utilized the PRISMA framework used the following keyword combinations: (depression OR suicide OR apathy) AND (MTBI OR "Mild traumatic brain injury" OR concussion) AND ("acute phase" OR "short-term" OR "short term" OR "early"). Articles were included in the final analysis if: completed on an athletic or physically active population, evaluated depressive symptoms after a concussion was sustained, and were not completed on elderly patients. Year published, level of evidence, participant demographics, patient outcomes, and various depression and mood scale scores were extracted from the final selection of articles. The present study was limited by utilizing a single research database. Results: Of the 203 articles identified through the database search, 13 studies were included in this review. Main themes across the collection of studies included depression, anxiety, and irritability and mood liability. Four studies identified depressive symptoms with comorbid anxiety symptoms and eight studies identified comorbidities or measured total mood disturbances in addition to depression. Further, two studies identified mood lability and irritability as specific depressive symptoms post-concussion. Four studies compared concussed patients to non-concussed patients and musculoskeletal patients and had conflicting results on whether concussion patients experienced depression symptoms longer or worse than non-concussion patients. Conclusions: Rates of depression, anxiety, irritability, and mood lability are significantly greater in the acute phase of concussion recovery; however, these rates do not necessarily have an impact on return to play decisions except when severely impacting a patient’s ability to perform in the classroom or social settings. In many cases, these symptoms reduced approximately two weeks post-concussion. This systematic review demonstrated the relationship between concussions, psychological symptoms, and post-concussion outcomes. These data provide rationale for better psychological screening tests in baseline and post-concussion testing. Future research is necessary to determine the utility of waiting to return athletes to play until after psychological symptoms have returned to baseline levels.
Acute Depressive Symptoms Post-Concussion: A Systematic Review
UC 326
Context: Athletes who sustain an injury may experience depression, anxiety, tension, fear, and low self-esteem due to being taken out of their sport and changing their daily activities. These acute and chronic emotional or mood disturbances are common and highly studied in concussion patients; however, acute consequences of concussions are not as well understood. This review will seek to clarify the understanding of acute mood disturbances and depressive symptoms post-concussion in a physically active population based on the current available literature. This will provide information for healthcare providers to use in athletes’ return to play decisions and follow-up care post-concussion. This information also allows better understanding and education available to athletes, parents, coaches, teachers, school administrators, and many other people who play integral roles in athletes’ healing after a concussion. Methods: A systematic literature search was completed in October 2019 via the PubMed database to include articles published between 2004 and 2019. The search utilized the PRISMA framework used the following keyword combinations: (depression OR suicide OR apathy) AND (MTBI OR "Mild traumatic brain injury" OR concussion) AND ("acute phase" OR "short-term" OR "short term" OR "early"). Articles were included in the final analysis if: completed on an athletic or physically active population, evaluated depressive symptoms after a concussion was sustained, and were not completed on elderly patients. Year published, level of evidence, participant demographics, patient outcomes, and various depression and mood scale scores were extracted from the final selection of articles. The present study was limited by utilizing a single research database. Results: Of the 203 articles identified through the database search, 13 studies were included in this review. Main themes across the collection of studies included depression, anxiety, and irritability and mood liability. Four studies identified depressive symptoms with comorbid anxiety symptoms and eight studies identified comorbidities or measured total mood disturbances in addition to depression. Further, two studies identified mood lability and irritability as specific depressive symptoms post-concussion. Four studies compared concussed patients to non-concussed patients and musculoskeletal patients and had conflicting results on whether concussion patients experienced depression symptoms longer or worse than non-concussion patients. Conclusions: Rates of depression, anxiety, irritability, and mood lability are significantly greater in the acute phase of concussion recovery; however, these rates do not necessarily have an impact on return to play decisions except when severely impacting a patient’s ability to perform in the classroom or social settings. In many cases, these symptoms reduced approximately two weeks post-concussion. This systematic review demonstrated the relationship between concussions, psychological symptoms, and post-concussion outcomes. These data provide rationale for better psychological screening tests in baseline and post-concussion testing. Future research is necessary to determine the utility of waiting to return athletes to play until after psychological symptoms have returned to baseline levels.