Concussion characteristics in children and adolescents with ADHD: Exploring symptom burden and recovery trajectories

Concussions are a significant health concern for pediatric populations as children and adolescents engage in sports and recreational activities that increase their likelihood of sustaining brain injuries. Physical, cognitive, and emotional symptoms resulting from concussion overlap with other diagnoses, particularly mimicking many symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD). This study aimed to investigate and compare concussion characteristics, including symptom burden and recovery timeline, among pediatric patients with and without ADHD who have been diagnosed with a concussion. A retrospective chart review of 316 patients aged 6-18 years seen in a specialty concussion clinic in the Northwest United States was conducted. Patients with ADHD were selected, and patients without a positive developmental history were selected as an age-matched control group. Data from initial phone interviews and the Rivermead Post-Concussion Symptoms Questionnaire were recorded into Epic EHR. Variables included demographics, concussion details, and symptom severity. Younger patients with ADHD had a longer time to their first visit, but ADHD did not significantly impact overall recovery time. Adolescents with ADHD and concussion were more likely to have diagnoses of depression and anxiety than adolescents without ADHD who had a concussion. The findings highlight the complexity of outcomes following concussion in children and adolescents. Although ADHD was associated with delayed care-seeking and higher rates of depression and anxiety diagnoses, an ADHD diagnosis did not significantly affect concussion symptom burden, as measured by the Rivermead Post-Concussion Symptoms Questionnaire, or recovery timeline.