A - 42 Severity of Sport-Related Concussion Symptomatology Predicts Long-term Self-reported Physical and Mental Health Symptoms in Young Athletes

Abstract Purpose This study examined the relationship between initial concussion symptom severity and long-term neurobehavioral, anxiety, and depressive symptoms in former adolescent athletes. Method In 2023, a survey was sent to patients treated at a regional sports concussion center between 2010–2017. Participants self-reported demographics, medical history, and current symptoms. Initial concussion data was obtained via chart review. Primary outcomes were Neurobehavioral Symptom Inventory (NSI), General Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9) scores. Multivariate regression analyzed whether initial total Post-Concussion Symptom Scale (PCSS) scores predicted long-term outcomes. Results The cohort included 76 participants (current age 24.1 ± 2.5 years; 8.5 ± 1.5 years follow-up). Age at initial injury was 15.6 ± 2.2. Current NSI, GAD-7, and PHQ-9 scores did not differ significantly based on demographics or health history. Amnesia at injury was associated with higher NSI (p = 0.040) and GAD-7 (p = 0.004) at follow-up. Initial PCSS significantly predicted long-term NSI score (B = 0.301, p = 0.001, R2 = 0.262) and GAD-7 (B = 0.089, p = 0.009, R2 = 0.158) while controlling for other demographic, health history, concussion history, and family health history factors. The omnibus model predicting PHQ-9 score was not significant (p = 0.074), though initial PCSS remained a predictor (B = 0.074, p = 0.004). Conclusions Higher initial symptom scores predicted higher long-term NSI, GAD-7, and PHQ-9 scores 8.5 years after concussion. Amnesia at injury was also associated with greater NSI and GAD-7 scores. These findings suggest initial concussion severity may influence long-term symptoms, emphasizing early symptom management to reduce adverse outcomes.