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Abstract
Objective To investigate the association between concussion history and depressive symptoms after adjusting for physical activity, substance use, and illicit drug use.
Methods We analysed data from the Adolescent Behaviour and Experiences Survey, a nationally representative survey of adolescents in the USA. Our independent variables were history of concussion in the 12 months preceding survey completion; self-reported weekly physical activity (days per week with >60 min of physical activity, 0–7 scale); substance use over the past 30 days (yes vs no) and illicit drug use throughout lifetime (yes vs no). Our dependent variable was participant-reported sadness/hopelessness over the past 12 months (yes vs no).
Results Among 7499 adolescents (9th–12th grade, 50.4% female), reporting one or more concussions over the past year was not associated with the odds of depressive symptoms (OR: 1.13, 95% CI: 0.93 to 1.37, p=0.21). Each additional day of physical activity per week was associated with a lower odds of depressive symptoms (OR: 0.91; 95% CI: 0.89 to 0.94; p<0.0001). Illicit drug use (OR ever vs never: 2.48; 95% CI: 1.96 to 3.13; p<0.0001) and substance use (OR yes vs no: 2.77; 95% CI: 2.34 to 3.29; p<0.001) were associated with a higher odds of depressive symptoms.
Conclusions Adjusting for physical activity, substance use and illicit drug use, concussion was not significantly associated with depressive symptoms. This novel discovery informs clinicians as they counsel adolescents with concussion; future research should examine physical activity and avoidance of substance/illicit drug use as postinjury recommendations in an effort to lower the risk of depressive symptoms.
- Depression
- Drug and Narcotic Control
- Head
- Brain Concussion
Data availability statement
Data are available in a public, open access repository. We analysed data from the Adolescent Behaviour and Experiences Survey (ABES), a nationally representative survey of health and behavioural-related outcomes among adolescents. The ABES is a stratified, three-stage cluster probability-based survey which enrolled adolescent-aged high school students in public and private schools across the USA.
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Data availability statement
Data are available in a public, open access repository. We analysed data from the Adolescent Behaviour and Experiences Survey (ABES), a nationally representative survey of health and behavioural-related outcomes among adolescents. The ABES is a stratified, three-stage cluster probability-based survey which enrolled adolescent-aged high school students in public and private schools across the USA.
Footnotes
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Contributors MJW contributed to the idea development, drafted the initial manuscript, assisted with the statistical analysis and revised the manuscript. PC contributed to the idea development, conducted the statistical analysis and revised the manuscript. RM, TM, KLS, JCW and DH contributed to the idea development and revised the manuscript. All authors approved the final manuscript as submitted and agreed to be accountable for all aspects of the work. DH is the guarantor.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests Unrelated to this study, DH has received research support from the Eunice Kennedy Shriver National Institute of Child Health & Human Development (R03HD094560, R01HD108133), the National Institute of Neurological Disorders And Stroke (R01NS100952, R43NS108823), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (1R13AR080451), MINDSOURCE Brain Injury Network, the Tai Foundation and the Colorado Clinical and Translational Sciences Institute (UL1 TR002535‐05) and he serves on the Scientific/Medical Advisory Board of Synaptek. TM has received compensation as a member of the Clinical and Scientific Advisory Board for Quadrant Biosciences. The remaining authors declare no conflicts of interest.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.
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