Mental Health Outcomes of Elite Athletes Following Sport-Related Concussion

Abstract

The purpose of this research was to elucidate the short and long-term mental health outcomes following sport-related concussion (SRC) in a population of elite athletes. Specifically, symptoms consistent with anxiety, depression, and psychological distress were investigated in a population of 196 male professional and collegiate football players ages 18 to 34 years old. All athletes completed self-report measures (PHQ-9, GAD-7, and BSI-18) at baseline. Athletes who sustained a SRC (n = 16) in season as well as musculoskeletal (MSK) (n = 13) and healthy control (n = 21) athletes completed the PHQ-9 and GAD-7 at three time points. Results from the study indicated that athletes with a history of one or more SRCs reported greater symptoms of depression (F(2, 193) = 10.88, p < .001, partial eta squared = .10), anxiety (F(2, 193) = 13.67, p < .001, partial eta squared = .12), and psychological distress (F(2, 193) = 18.01, p < .001, partial eta squared = .16) at baseline in comparison to athletes with no history of SRC. Additionally, athletes who sustained a SRC reported greater levels of depression and anxiety at 24-48 hours post injury in comparison to the MSK and healthy control groups. No differences between groups were detected at later time points suggesting that this increase in depression and anxiety symptoms was short term. Finally, analysis at the individual level showed that 50% of SRC athletes demonstrated a reliable change from baseline to 24-48 hours post injury on the depression and/or anxiety self-report in comparison to 33% of MSK injured athletes and 17% of healthy controls. In addition, 58% of athletes who sustained a SRC reported a reliable decrease in depression and/or anxiety symptoms at one month return to play, suggesting that they were experiencing fewer anxiety and depression symptoms in comparison to baseline. Taken together, this research suggests that a history of SRC impacts baseline self-report of depression, anxiety, and psychological distress. Furthermore, athletes who sustain a SRC experience subtle increases in depression and anxiety symptoms in the short term that appear to be unique to concussion. However, the athletes’ self-reported depression and anxiety symptoms did not reach clinical levels and were short lived.