Sleep problems, depression, are risk factors for lower quality-of-life scores after concussion
By Sravya Valiveti. This article was initially published in the 12/19/24 edition of our Concussion Update newsletter; please consider subscribing.
A recent study published in the Journal of Pediatrics by researchers Jamie Shoop et al. studied health-related quality of life (HRQL) metrics and other psychological factors post-concussion in youth over a 12-month period. They found that psychological risk factors such as anxiety and depression negatively impact health-related quality of life in the initial 6-month phase of pediatric concussion, followed by steady improvement over the following six months. The study authors urged that healthcare providers should not overlook negative psychological changes immediately following a concussion, as they could serve as indicators of the risk for poor recovery outcomes.
A Children’s Hospital of Philadelphia (CHOP) press release emphasized that sleep disturbance and depressive symptoms, in particular, are two key risk factors linked to significantly lower HQRL following concussion, “demonstrating how concussion can have a ripple effect, impacting not only how a child feels physically and emotionally but also how they perform at school and in their relationships with friends and family.” Dr. Sloop emphasized that while the HRQL changes are transitory, it’s essential for healthcare providers to provide support for “cognitive and social-emotional symptoms following injury.”
The study evaluated 49 concussed patients who were receiving care at a specialty concussion program (the Minds Matter Concussion Program at CHOP). The concussed patients (median age 15.4 years) were followed to monitor health-related quality of life changes and completed self-reported HRQL questionnaires regularly across the 12-month period. The data was compared to that of non-concussed control patients who also completed these assessments. Health-related quality of life was found to be significantly lower in the 6 months post-injury in concussed adolescents, followed by gradual improvement over the next 6 months after the initial clinical assessment. Some of the key factors that the authors considered were mental health history prior to concussion, presence of pre-injury or current symptoms of anxiety and depression, sleep disturbance, and poorer results on the Short Grit Scale (which measures perseverance)––all of which negatively impacted HRQL in the initial phase.
Examining these quality-of-life measures and psychological changes in youth can help inform better quality of care in the acute phase post-concussion and provide comprehensive support that takes adolescent concussion patients’ physical, cognitive, and socio-emotional well-being into account.