Psychological symptoms following concussion may impair recovery in high school athletes
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Key takeaways:
- Results showed 45% of patients had at least one psychological symptom following a sport-related concussion.
- Symptoms were associated with delayed return to learn, return to sport and symptom resolution.
Published data showed psychological symptoms following sport-related concussions are common in high school athletes and may delay their recovery.
“Athletes who endorsed acute psychological symptoms after a sport-related concussion were found to achieve full recovery slower than those without acute psychological symptoms,” Maryam Y. Jawid, BS, of Vanderbilt University Medical Center, told Healio.
Jawid and colleagues retrospectively analyzed data on 431 high school athletes (aged 14 to 18 years) who sustained a sport-related concussion between November 2017 and April 2022. Concussions sustained during American football were excluded.
Patients completed a patient-reported post-concussion symptom scale (PCSS) during the first clinic visit. Jawid and colleagues then derived a psychological symptom cluster score, which utilized the cumulative score of each domain on the PCSS (cognitive, physical, affective and sleep), as well as a psychological symptom cluster ratio, which divided the psychological symptom cluster score by the PCSS.
Outcomes measured included time to return to learn, symptom resolution and time to return to play.
According to the study, 45% of the cohort reported at least one psychological symptom following their concussion. Results showed 38.1% of patients reported irritability, 30.2% reported feeling more emotional, 25.3% reported nervousness and 22% reported sadness.
In addition, Jawid and colleagues found that female sex, loss of consciousness, retrograde/anterograde amnesia and history of psychological disorder were predictors of a higher psychological symptom cluster score.
Researchers also found that female sex and psychological history were predictors of an increased psychological symptom ratio, while migraine history was a predictor of a decreased ratio.
In terms of recovery, increased psychological symptom cluster scores and psychological symptom cluster ratios were both associated with longer times to return to learn, symptom resolution and return to play, according to the study.
“Psychological symptoms are a key aspect of sport-related concussion evaluation and treatment and should not be overlooked,” Jawid said. “In some circles, endorsing psychological symptoms may be stigmatized and lead others to have negative connotations about the athlete’s character — in our opinion, that could not be more inaccurate. High- level sports are stressful, school is stressful and getting a head injury adds a lot of stress on top of all that. Athletes being proactive about their psychological symptoms and seeking help may lead to a quicker recovery.”
She added, “We plan to expand our work to include larger cohorts and different age groups beyond high-school age, including middle school and collegiate athletes.”
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