Nine-Year Risk of Depression Diagnosis Increases With Increasing Self-Reported Concussions in Retired Professional Football Players
ABSTRACT Concussions may accelerate the progression to long-term mental health outcomes such as depression in athletes.
To prospectively determine the effects of recurrent concussions on the clinical diagnosis of depression in a group of retired football players.
Cohort study; Level of evidence, 2.
Members of the National Football League Retired Players Association responded to a baseline General Health Survey (GHS) in 2001. They also completed a follow-up survey in 2010. Both surveys asked about demographic information, number of concussions sustained during their professional football career, physical/mental health, and prevalence of diagnosed medical conditions. A physical component summary (Short Form 36 Measurement Model for Functional Assessment of Health and Well-Being [SF-36 PCS]) was calculated from responses for physical health. The main exposure, the history of concussions during the professional playing career (self-report recalled in 2010), was stratified into 5 categories: 0 (referent), 1 to 2, 3 to 4, 5 to 9, and 10+ concussions. The main outcome was a clinical diagnosis of depression between the baseline and follow-up GHS. Classic tabular methods computed crude risk ratios. Binomial regression with a Poisson residual and robust variance estimation to stabilize the fitting algorithm estimated adjusted risk ratios. χ(2) analyses identified associations and trends between concussion history and the 9-year risk of a depression diagnosis.
Of the 1044 respondents with complete data from the baseline and follow-up GHS, 106 (10.2%) reported being clinically diagnosed as depressed between the baseline and follow-up GHS. Approximately 65% of all respondents self-reported sustaining at least 1 concussion during their professional careers. The 9-year risk of a depression diagnosis increased with an increasing number of self-reported concussions, ranging from 3.0% in the "no concussions" group to 26.8% in the "10+" group (linear trend: P < .001). A strong dose-response relationship was observed even after controlling for confounders (years retired from professional football and 2001 SF-36 PCS). Retired athletes with a depression diagnosis also had a lower SF-36 PCS before diagnosis. The association between concussions and depression was independent of the relationship between decreased physical health and depression.
Professional football players self-reporting concussions are at greater risk for having depressive episodes later in life compared with those retired players self-reporting no concussions.
- SourceAvailable from: PubMed Central
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- "Even in the absence of CTE, professional athletes with repeated concussions have higher risk of cognitive impairment  and depression . A 9 year prospective study of retired professional football players found a dose-response relationship between number of concussions and risk of developing depression . Student athletes that sustain 3 or more concussions also report decreased quality of life, including social functioning, compared to those that received 2 or fewer concussions . "
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Article: Melancholy ThoughtsThe American Journal of Sports Medicine 10/2012; 40(10):2197-9. DOI:10.1177/0363546512462362 · 4.36 Impact Factor
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ABSTRACT: Sports neuropsychology has emerged as a specialty area within the field of clinical neuropsychology. The role of the sports neuropsychologist, rooted in baseline and post-concussion testing, has evolved to include other clinical domains, including the clinical assessment of potential draft picks. There is no published information on the neurocognitive characteristics of these draft picks. We sought to determine whether elite NFL draft picks differed from NFL roster athletes on neurocognitive (ImPACT) and biopsychosocial characteristics, and given that no published data exists for this population, adopted null hypotheses. Null hypotheses were rejected for two of the four ImPACT scores, as elite draft picks scored higher on measures of visual motor speed and reaction time than roster NFL athletes. Subtle but distinct neurocognitive differences are noted when comparing elite NFL draft picks with norms from a cumulative roster of a single NFL team.Archives of Clinical Neuropsychology 12/2012; 28(1). DOI:10.1093/arclin/acs108 · 1.99 Impact Factor