Preexisting Mental Health Disorders Are Associated With Acute Clinical Presentation and Longitudinal Recovery Trajectories in Adolescents With Concussion.

Iuliano SG, Gagnon IJ, Iverson GL, Cook NE, Zemek R, Teel EF.

Research Support, Non-U.S. Gov'tOpen access

AI summary — for doctors, generated from the abstract only

In a large study of adolescents with concussion, preexisting anxiety or depression was associated with worse overall symptom severity and quality of life during recovery, though the trajectory of recovery over time and ultimate risk of persistent symptoms were similar to those without preexisting mental health conditions.

What was studied

A secondary analysis of 1,238 adolescents (ages 13-17) with concussion examined the association between preexisting mental health conditions (anxiety, depression, or combined anxiety/depression, compared with a control group without these conditions) and clinical recovery, using the Post-Concussion Symptom Inventory (PCSI) within 48 hours and over 3 months, and the Pediatric Quality of Life Inventory (PedsQL), with multivariable models examining persistent post-concussion symptoms (PPCS).

Key findings

A main effect of preexisting mental health group was present for acute symptom scores (P=.03), though post-hoc comparisons between specific groups were not statistically significant
Main effects of group and time were observed for both PCSI symptom and PedsQL quality-of-life outcomes over the 3-month follow-up, with preexisting mental health groups showing worse overall scores
In univariate models, there was an association between preexisting mental health conditions and some outcome (P=.02, specific outcome not fully specified in available text), but multivariable models found no significant association between preexisting mental health conditions and presence of persistent post-concussion symptoms (P=.62)
Overall, preexisting mental health conditions were associated with similar longitudinal recovery trajectories but higher symptom burden and lower quality of life scores throughout recovery

Clinical relevance

The findings suggest that adolescents with preexisting anxiety or depression experience a similar overall recovery trajectory after concussion but with persistently higher symptom burden and lower quality of life compared with those without such conditions, which the authors suggest highlights the importance of considering mental health history in concussion management, even though preexisting mental health conditions did not independently predict developing persistent post-concussion syndrome in adjusted analyses.

Who should care

Pediatric Neurology

Limitations

This was a secondary analysis of existing data, which limits the specificity of pre-planned hypothesis testing; post-hoc comparisons for the acute symptom group effect were not statistically significant despite an overall significant main effect, indicating some results should be interpreted cautiously.

Adolescents with preexisting anxiety or depression had higher symptom burden and lower quality of life throughout concussion recovery, but similar overall recovery trajectories and no independent increased risk of persistent post-concussion symptoms after adjustment, underscoring the importance of considering mental health history in concussion care.

This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.

Abstract

This secondary analysis examined the association between preexisting mental health conditions and clinical recovery trajectories in adolescents with concussion. Adolescents (13-17; n = 1238) completed clinical assessments (Post-Concussion Symptom Inventory [PCSI] ≤48 hours postinjury; PCSI/ Pediatric Quality of Life [PedsQL] for 3 months) and were categorized into control, anxiety, depression, or combined anxiety/depression groups. Acute outcomes were analyzed using analysis of variance or χ2, whereas linear and logistic regression analyzed recovery trajectories. A main effect of group was present for acute symptom scores (P = .03), but post-hoc testing revealed no significant comparisons. Main effects of group and time were observed for PCSI and PedsQL outcomes (P P = .02) in univariate models. However, multivariable models found no association between preexisting mental health conditions and the presence of PPCS (P = .62). Preexisting mental health conditions were associated with similar longitudinal trajectories but higher symptom and lower quality of life scores overall, highlighting their importance in adolescent concussion management.

DOI

10.1177/08830738251408113

PMID

41505351

PMCID

PMC13522415

Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.

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