Post-concussive depression: evaluating depressive symptoms following concussion in adolescents and its effects on executive function

ABSTRACT

Background: Post-concussive depression describes an elevation of depressive symptoms following concussion that occurs in conjunction with other symptoms of concussion. Children with concussion are more likely to diagnosed with depression. The overlapping symptoms between clinical depression and concussion make the diagnosis of depression difficult. The purpose of this study is to explore how post-concussive depression relates to post-concussion symptoms and cognition by investigating symptom-reporting in youth with post-concussive depression and executive function.

Methods: Adolescents (age 10–17 years) diagnosed with concussion were divided into two groups based on depression scores on the Children’s Depression Inventory (post-concussion depression; non-depression groups). Symptom reporting on the Post-Concussion Symptom Inventory and performance on Immediate Post-concussion Assessment and Cognitive Testing (ImPACT) were compared.

Results: Participants with post-concussive depression had heightened emotionality, irritability, and nervousness. Sadness and fatigue were reported by both groups. ImPACT was unable to distinguish between groups but the group overall demonstrated severe neurocognitive deficits.

Conclusion: Reports of greater emotionality, irritability, and nervousness on concussion symptom scales may be indicators of post-concussion depression. It is important for clinicians to take note when an adolescent with concussion scores high on these three emotional symptoms as they may be indicative of greater emotional distress.

KEYWORDS:

• Concussion
• adolescents
• depression
• post-concussive depression
• symptoms
• cognition

Acknowledgments

The authors would like to thank CIHR for funding this project. They would also like to acknowledge the nurses and doctors of the McMaster University Children’s Hospital, Chia-Yu Lin, Sarah Randall, Everett Claridge, Rachael Leighfield, and Conor Sheridan for their support to the project through recruitment and project administration. Lastly, this project would not have been possible without the participants and their families who contributed their time and efforts in the support for pediatric concussion research.

Disclosure of interest

The authors report no conflict of interest.

Additional information

Funding

This work was supported by the Canadian Institutes of Health Research [312571].