Original article
Prevalence of Diagnosed Depression in Adolescents With History of Concussion

https://doi.org/10.1016/j.jadohealth.2013.10.006Get rights and content

Abstract

Purpose

Previous studies in adults have suggested concussion and other brain injury presents a risk factor for depression. The goal of our study was to analyze the association between previous concussion and current depression diagnosis in a large nationally representative adolescent data set.

Methods

Retrospective cohort study using the National Survey of Children's Health 2007–2008, a nationally representative survey conducted via random digit dialing. Data were obtained by parental report. We included youth 12–17 years old without a current concussion (N = 36,060), and evaluated the association between previous concussion (binary) and current depression diagnosis (binary) using multiple logistic regression to control for age, sex, parental mental health, and socioeconomic status.

Results

After controlling for age, sex, parental mental health, and socioeconomic status, history of concussion was associated with a 3.3-fold greater risk for depression diagnosis (95% CI: 2.0–5.5). Other factors significantly associated with depression diagnosis included poor or fair parental mental health (OR: 3.7, 95% CI: 2.8–4.9), and older age (15–17 years vs. 12–14 years, OR: 1.4, 95% CI: 1.1–1.8). Sex of the subject was not significantly related to depression diagnosis. Being above 200% of the poverty level was associated with approximately a 50% decreased risk of depression diagnosis (95% CI: 35%–70%).

Conclusions

History of concussion was associated with a higher prevalence of diagnosed depression in a large nationally representative adolescent data set. Clinicians should screen for depression in their adolescent patients with concussion. Future studies should confirm this association using prospective methodology and examine potential treatment approaches.

Section snippets

Data source

The National Survey of Children's Health 2007 [18] is a telephone survey of parents administrated by the Maternal and Child Health Bureau, U.S. Department of Health and Human Services. The survey was conducted in several waves, and we used data from the 2007–2008 survey only. Phone numbers were selected by random digit dialing to identify households with one or more children under 18 years old, and one of those children was randomly selected to be discussed. If respondents reported no children

Results

Data from 36,060 individuals met the criteria for analysis; of these 49.2% were female (Table 1). A small proportion of these subjects had had a previous concussion (2.7%) and a similarly small number had a current depression diagnosis (3.4%). There were slightly more males than females (50.8% vs. 49.2%) and slightly more younger adolescents than older adolescents (50.8% vs. 49.2%). Few of these subjects (10.7%) had parents with poor or fair mental health and it was uncommon (15.2%) for

Discussion

In this secondary analysis of data from the National Survey of Children's Health we found that history of concussion was associated with greater than a 3-fold risk of a current diagnosis of depression, even after controlling for age, sex, parental mental health, and socioeconomic status. This study adds to the evidence for an association between concussion and depression [9], [10], [11], [12], [13], [14], [15] and is the first study to find such an association in a large nationally

References (38)

  • L.P. Richardson et al.

    A longitudinal evaluation of adolescent depression and adult obesity

    Arch Pediatr Adolesc Med

    (2003)
  • G. Saluja et al.

    Prevalence of and risk factors for depressive symptoms among young adolescents

    Arch Pediatr Adolesc Med

    (2004)
  • P.M. Lewinsohn et al.

    Adolescent psychopathology: I. Prevalence and incidence of depression and other DSM-III-R disorders in high school students

    J Abnorm Psychol

    (1993)
  • T. Holsinger et al.

    Head injury in early adulthood and the lifetime risk of depression

    Arch Gen Psychiatry

    (2002)
  • K.M. Guskiewicz et al.

    Recurrent concussion and risk of depression in retired professional football players

    Med Sci Sports Exerc

    (2007)
  • J.R. Fann et al.

    Psychiatric illness following traumatic brain injury in an adult health maintenance organization population

    Arch Gen Psychiatry

    (2004)
  • D.F. Zatzick et al.

    Association between traumatic injury and psychiatric disorders and medication prescription to youths aged 10–19

    Psychiatr Serv

    (2011)
  • S.S. O'Connor et al.

    Association between posttraumatic stress, depression, and functional impairments in adolescents 24 months after traumatic brain injury

    J Trauma Stress

    (2012)
  • Chopp F, Owen B, Gregoire C. Youth sports—head injury policies. Engrossed House bill 1824. Available at:...
  • Cited by (106)

    View all citing articles on Scopus
    View full text