Acute effects of sport-related concussion among adolescents with a self-reported history of treatment for anxiety or depression.

Objective: This study compared symptom reporting and cognitive test performance within 72 h of a suspected concussion between high school student-athletes with and without pre-injury self-reported mental health treatment. Methods: Eight hundred seventy-nine high school athletes with (n = 75) and without (n = 804) a self-reported history of treatment for anxiety or depression underwent preseason baseline testing, and post-injury testing within 72 h of suspected concussion. Results: At baseline, adolescents with a self-reported history of treatment for anxiety or depression (n = 75, 8.5%) endorsed significantly greater affective (Cohen's d = 0.70), cognitive (d = 0.52), physical (d = 0.53), and sleep-arousal (d = 0.50) symptoms compared to those with no mental health treatment history (n = 804). There was not a statistically significant group-by-time interaction for the total symptom severity score (F(4, 874)=2.27; p=.06), indicating that the magnitude of acute symptom worsening following concussion did not appear to differ in association with pre-injury mental health status. There were no significant group differences in neurocognitive composite scores at baseline or following concussion. Similarly, adolescents with self-reported history of treatment for anxiety or depression not more likely to exceed the reliable change cutoffs for worsening symptoms or cognitive functioning as compared to those without a self-reported history of treatment for anxiety or depression. Conclusions: Although there was no difference in the magnitude of change from baseline to post-injury symptom scores between the two groups, adolescents with pre-injury mental health difficulties reported more symptoms at baseline and acutely following a concussion. Adolescents with a self-reported history of treatment for anxiety or depression did not differ from those without on cognitive scores at baseline or following concussion.