Depression and Anxiety Have a Greater Association With Postconcussion Symptoms Than a Remote History of Sport-Related Concussion in College Students

The Post-Concussion Symptom Scale (PCSS) measures cognitive, sleep-arousal, physical, and affective symptoms that typically follow sport-related concussion (SRC). Mental health symptoms are associated with postconcussion-like symptoms, regardless of concussion status. This study examined whether mental health or SRC history had a stronger relation with symptom reporting and investigated the association between PCSS scores and perceived academic functioning. College students (N = 554) reported SRC history, current anxiety and depression symptoms, and academic self-efficacy. Participants were divided into healthy, SRC, anxiety, and depression groups then compared on individual symptom endorsement, symptom severity (total score and subscales), and academic self-efficacy. Healthy participants had lower endorsement rates than the anxiety/depression groups on all PCSS items (ps < .001) but vomiting, and lower symptom severity on each PCSS subscale and the total score (ps < .001, d range = .89 to 1.86). The healthy and SRC groups differed on only one item (i.e., trouble falling asleep, p < .001), one subscale (sleep-arousal, p < .01, d = .33), and the total score (p < .01, d = .27), with subtly greater severity in the SRC group. The cognitive subscale had the strongest relation with academic self-efficacy for every group (rho range = −.23 to −.36). Larger differences emerged when comparing healthy participants to those screening positive for anxiety/depression than those with an SRC history, indicating current mental health has a stronger relation with postconcussion-like symptoms than remote SRCs. Cognitive symptoms were strongly associated with perceived academic ability. In college students with a history of SRC, mental health symptoms may explain lasting symptoms and necessitate intervention for academic performance. What is the significance of this article for the general public? Following an SRC, college students may experience an array of postconcussion-like cognitive, physical, and emotional symptoms. Current mental health (e.g., anxiety and depression) may, in part, explain these elevated symptoms when they persist following an SRC beyond typical recovery time (e.g., greater than 3 months). Students with SRCs and cooccurring mental health problems may benefit from intervention to help with academic performances.