Details

Autor(en) / Beteiligte

• Thomas, Garrett A.
• Guty, Erin T.
• Riegler, Kaitlin E.
• Bradson, Megan L.
• Arnett, Peter A.
• Frydman, Jason S
• Ozurk, Erin D
• Nolin, Sara A
• Merritt, Victoria C
• Goodwin, Grace J
• Weiss, Daniel J

Titel

Affective Comorbidity or Concussion: Can We Tell the Difference?

Ist Teil von

• Translational issues in psychological science, 2023-03, Vol.9 (1), p.79-91

Ort / Verlag

Washingon: Educational Publishing Foundation

Erscheinungsjahr

2023

Quelle

EBSCO_PsycARTICLES

Beschreibungen/Notizen

• Sport-related concussion is associated with deficits in numerous domains of cognition and an increase in symptom reporting on postconcussion symptom scales. However, previous research has indicated that mood disturbance also impacts performance and symptom reporting at baseline. To fully grasp the potential impact of mood disturbance on cognitive performance, the current study aims to compare athletes with affective comorbidity (depression/anxiety) at baseline to those without mood disturbance following concussion. One hundred nineteen athletes completed a comprehensive neuropsychological battery at baseline and/or within 14 days postconcussion. Athletes were separated into 2 groups (Baseline Comorbid Depression/Anxiety and Postconcussion Healthy Mood) based on affective symptomatology and injury status. Groups were compared on mean neurocognitive performance scores and algorithm-derived classifications of neurocognitive impairment. Groups were also compared on Post-Concussion Symptom Scale (PCSS) symptom reporting, both total score and by symptom cluster. We found no significant differences in neurocognitive performance between groups. The Baseline Comorbid Depression/Anxiety group reported significantly more total symptoms, and more affective and sleep symptoms, compared to the postconcussion group. Neurocognitively, athletes with mood disturbance at baseline looked comparable to athletes who recently sustained concussion. Surprisingly, the Baseline Comorbid Depression/Anxiety group reported greater levels of symptomatology on the PCSS despite not experiencing recent concussion. These findings highlight the importance of screening for affective symptoms at baseline to identify athletes with underlying conditions that may be comorbid with future concussion. Without accurate baseline data, postconcussion assessments may be skewed and may lead to these athletes being withheld from activity longer than necessary. What is the significance of this article for the general public? It is evident that TBI is a public health crisis, yet there is a lack of consensus on the best approach to concussion assessment and management. The baseline model has long been considered the standard approach, though it has come under criticism in recent years. This said, our findings suggest that baseline testing may be critical for certain populations, particularly those with conditions that may be comorbid with concussion, like co-occurring depression and anxiety, which can complicate postconcussion comparisons. Having an accurate baseline for these athletes, as well as a better understanding of ways in which depression and anxiety may influence neuropsychological testing and symptom reporting, can help to inform return-to-learn and return-to-play decisions and may prevent athletes from being withheld from activity unduly.