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Int J Sports Med 2020; 41(10): 682-687
DOI: 10.1055/a-1107-3025
Clinical Sciences

Symptom Presentation After Concussion and Pre-existing Anxiety Among Youth Athletes

Matthew Kent
1   Department of Psychology University of Pittsburgh, Pittsburgh, United States
,
Anna Brilliant
2   Department of Sports Medicine, Children’s Hospital Boston, Boston, United States
,
Kirk Erickson
1   Department of Psychology University of Pittsburgh, Pittsburgh, United States
,
William Meehan
3   Department of Sports Medicine, The Micheli Center for Sports Injury Prevention, Waltham, United States
,
David Howell
4   Department of Orthopedics, University of Colorado Denver School of Medicine, Aurora, United States
5   Sports Medicine Center, Children’s Hospital Colorado, Aurora, CO, USA
› Author Affiliations Funding: There was no funding provided for this study. Dr. Howell has received research support from the Eunice Kennedy Shriver National Institute of Child Health & Human Development (R03HD094560), the National Institute of Neurological Disorders And Stroke (R01NS100952, R03HD094560, and R43NS108823), and MINDSOURCE Brain Injury Network. Dr. Meehan receives royalties from 1) ABC-Clio publishing for the sale of his books, Kids, Sports, and Concussion: A guide for coaches and parents, and Concussions; 2) Springer International for the book Head and Neck Injuries in the Young Athlete and 3) Wolters Kluwer for working as an author for UpToDate. His research is funded, in part, by philanthropic support from the National Hockey League Alumni Association through the Corey C. Griffin Pro-Am Tournament and a grant from the National Football League. The remaining authors have conflicts to disclose.
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Abstract

Our purpose was to evaluate the effect of self-reported pre-injury anxiety diagnosis on persistent symptom development, vestibular symptom severity, and balance control among youth who sustained a concussion. We performed a retrospective study of patients seen at a specialty pediatric concussion clinic. Patients were 18 years of age or younger, examined within 10 days of concussion, and received care until full recovery. A questionnaire was used to assess pre-existing medical and psychiatric conditions, including anxiety. Our main outcomes were prolonged symptom recovery defined as persistent symptoms for > 28 days after concussion) and severity of vestibular symptoms. Patients who reported pre-injury anxiety (n=43; median age=14.9 years; 37% female) were more likely to experience symptoms>28 days post-injury (76 vs. 54%; p=0.04) than those without pre-existing anxiety (n=241; median age=14.9 years; 53% female). After adjusting for sex, history of migraine, depression and ADHD, however, there was no independent association between pre-existing anxiety and prolonged symptom duration (adjusted odds ratio=2.34; 95% CI=0.083–6.63; p=0.11). Pre-existing anxiety was independently associated with self-reported nausea/vomiting severity (β coefficient=0.59, 95% CI=0.07–1.11). A pre-existing anxiety diagnosis does not appear to be associated with persistent symptoms after concussion, although it may be associated with post-injury nausea.

Key words

adolescent - mild traumatic brain injury - anxiety - mental health - sports


Publication History

Received: 20 August 2019

Accepted: 09 January 2020

Article published online:
03 June 2020

© Georg Thieme Verlag KG
Stuttgart · New York

 

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