Abstract
Our purpose was to evaluate the effect of self-reported pre-injury anxiety
diagnosis on persistent symptom development, vestibular symptom severity, and
balance control among youth who sustained a concussion. We performed a
retrospective study of patients seen at a specialty pediatric concussion clinic.
Patients were 18 years of age or younger, examined within 10 days of concussion,
and received care until full recovery. A questionnaire was used to assess
pre-existing medical and psychiatric conditions, including anxiety. Our main
outcomes were prolonged symptom recovery defined as persistent symptoms for
> 28 days after concussion) and severity of vestibular symptoms.
Patients who reported pre-injury anxiety (n=43; median age=14.9
years; 37% female) were more likely to experience symptoms>28
days post-injury (76 vs. 54%; p=0.04) than those without
pre-existing anxiety (n=241; median age=14.9 years; 53%
female). After adjusting for sex, history of migraine, depression and ADHD,
however, there was no independent association between pre-existing anxiety and
prolonged symptom duration (adjusted odds ratio=2.34; 95%
CI=0.083–6.63; p=0.11). Pre-existing anxiety was
independently associated with self-reported nausea/vomiting severity
(β coefficient=0.59, 95% CI=0.07–1.11).
A pre-existing anxiety diagnosis does not appear to be associated with
persistent symptoms after concussion, although it may be associated with
post-injury nausea.
Key words
adolescent - mild traumatic brain injury - anxiety - mental health - sports
