Study finds more pre-existing mental diagnoses associated with longer recovery time and higher emotional symptom burden
By Ike Smalley. This article was initially published in the 4/11/24 edition of our Concussion Update newsletter; please consider subscribing.
Researchers at the Children’s Hospital of Philadelphia (CHOP) recently published a study in Sports Health examining the relationship between pre-injury mental health diagnoses and post-concussion emotional symptom burden (and recovery time) in youth. The study analyzed the electronic health record data of 3,105 patients ages 5 to 18 years who visited a concussion care program after their injuries and followed their clinical recovery. Master et al. found that the existence of pre-injury mental health diagnoses correlated with longer concussion recovery time and increased emotional symptoms. The team also identified a novel result, finding a dose-response relationship: a greater number of mental health diagnoses intensified those effects.
Additionally, while female patients were more likely to experience prolonged recovery, male patients with prolonged recovery had a larger emotional symptom burden than female patients with prolonged recovery. A CHOP press release points out that girls, in general, have a greater mental health burden, and therefore, boys “may not be as actively screened and treated for mental health concerns to the same degree as girls are.” Universal screening for mental health is necessary, thus ensuring that boys with prolonged recovery receive support for emotional symptoms.
Patients with prior mental health diagnoses were also more likely to encounter other issues with concussion recovery, such as balance and vision problems or delayed return to activity. Individual mental health diagnoses such as anxiety, learning disabilities, depression, and disordered eating were also correlated with longer recovery times. The results support addressing pre-existing mental health problems as a part of concussion management and providing extra support for those with mental health diagnoses, such as support for visio-vestibular dysfunction and return to activity.
The study notes that the rates of pre-injury mental health diagnoses were higher than in earlier timeframes, illustrating the growing issue of mental health problems in youth. Combined with the finding that more mental health diagnoses correlate with worse concussion outcomes, these results are especially pertinent. Comorbid mental health conditions are widespread, meaning that people with one mental health issue are at greater risk for another and, therefore, may experience even larger concussion recovery challenges.