Study – Growing Evidence of Psychiatric Consequences Following Sport Concussion in Adults

Adding to this site’s summary of safety studies regarding combat sports, a recent literature review was published in this month’s Canadian Journal of Psychiatry addressing the link between adverse psychiatric consequences and adults who suffer concussions in sport.

In the article, titled “Knowing What We Don’t Know: Long-Term Psychiatric Outcomes following Adult Concussions in Sports” the authors reviewed 21 studies pertaining to depression, anxiety, substance use, and behavioural changes, including those highlighting chronic traumatic encephalopathy (CTE) searching for a link between sport concussion and these mental health outcomes.  The authors concluded that “There appears to be a growing body of evidence supporting the presence of long-term psychiatric and psychological sequelae following sport concussion in adults.”.

In an associated article the author notes “Specifically, in most studies, depressive symptoms were linked to concussion. The studies with regard to anxiety and also substance abuse were few, and findings were mixed with regard to a connection with concussion. Studies that focused on behavioural changes typically identified behaviour and/or cognitive changes after sports concussion, and a link was suggested in 2 studies. Chronic traumatic encephalopathy, a degenerative neurological disease that occurs years after concussion or repetitive head trauma, was included in this review. This broad syndrome is associated with mood, behavior, cognitive, and substance use problems. Clear subtypes and aetiologies have not yet emerged, but there is some evidence of symptom patterns of initial onset of cognitive problems followed by psychiatric complications or early psychiatric problems followed by cognitive decline“.

The full abstract is reproduced below –

Objective: Amidst a growing concern regarding concussion in sports, there is an emerging link between sport concussion and mental health outcomes. This review summarizes the current literature addressing long-term psychiatric sequelae associated with sport concussion in adults.

Method: Several databases were searched using a broad list of keywords for each ofconcussion, sports, and mental health, with a resultant 311 studies for initial review. After limiting studies based on duplication, appropriateness of data, and relevance, 21 studies remained pertaining to depression, anxiety, substance use, and behavioural changes, including those highlighting chronic traumatic encephalopathy (CTE).

Results: Most studies identified suggested an increased prevalence of depressive symptoms related to concussion history. A conference abstract and qualitative study suggested increasing anxiety related to concussion history; however, a PhD dissertation found no relationship. In reviewing substance use, several studies mentioned use in athletes suspected of having concussion histories, although no link was established, while another noted undiagnosed concussion as leading to current substance misuse. Regarding behavioural changes, all studies identified occurrences of behaviour and/or cognitive changes in participants, with 2 studies suggesting a link with concussion history. With respect to CTE, concerns with mood, behaviour, cognition, and substance use were consistently highlighted, suggesting relations to previous sport concussion; however, the notion of different CTE subtypes and clear aetiology behind concussion severity or frequency was not consistently elucidated.

Conclusion: There appears to be a growing body of evidence supporting the presence of long-term psychiatric and psychological sequelae following sport concussion in adults.

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