Combined Effects of Depression and Sport-Related Concussion on Neuropsychological Test Performance

Abstract

The goal of this study was to gain a deeper understanding of the ways in which the combination of depression and sport-related concussion (SRC) impact cognitive functioning and recovery time. Neuropsychological test-score differences between concussed athletes with and without pre-existing or post-concussive depression were examined. Participants included 2238 collegiate athletes who completed baseline testing between 2015 and 2019. Of those participants, 152 sustained concussions and were further investigated. The Patient Health Questionnaire (PHQ-9) was used to screen for depression at both baseline and post-concussion. Total scores of 5 or greater on the PHQ9 resulted in classification as depressed. Cognitive functioning was compared between non-depressed and depressed athletes at baseline and post-concussion using Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT). At baseline, depressed athletes demonstrated slower Reaction-Time than non-depressed athletes. At postconcussion, depressed athletes performed poorer on the Verbal Memory Composite. Visual Motor Speed Composite scores were worse among depressed athletes at both baseline and post-concussion. Reaction time did not appear to be influenced by depression. Findings show support for the inclusion of a depression screening measure at baseline and post-concussion to provide a broader understanding of cognitive functioning and mental health.