Research Reports - Long-term psychiatric outcomes following adult concussion in sports

Can J Psychiatry. 2016 May;61(5):270-6. doi: 10.1177/0706743716644953.

Finkbeiner NW(1), Max JE(2), Longman S(3), Debert C(4).

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
of concussion, 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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