A - 01 Association Between Co-occurring Depressive and Anxiety Symptoms and Post-Concussion Recovery Timelines

Abstract Purpose A growing body of evidence has highlighted the important role of affective symptoms in concussion recovery timelines. While most research has focused on affective symptoms broadly—or on depression or anxiety in isolation—there is a need to explore whether co-occurring depression and anxiety contribute to prolonged recovery. This study examined whether collegiate athletes endorsing co-occurring depression and anxiety within 24–48 hours post-concussion were at increased risk for longer recovery. Method 708 (F = 258) collegiate athletes completed post-concussion neuropsychological evaluation within 24-48 hrs of injury. Athletes were separated into four affective groups based on depression and anxiety scores self-reported during the post-concussion evaluation. Logistic regression was conducted with recovery type (Typical/Extended) as the outcome and affective group as the predictor. Results Sex and number of previous concussions were considered as covariates but did not significantly predict extended recovery (>14 days) in this study. Compared to athletes without depression or anxiety, only the co-occurring depression/anxiety group was at significantly increased risk for recovery beyond 14 days (O/R = 2.10, p = 0.004). Athletes with depression alone and anxiety alone were not at significantly increased risk for extended recovery compared to athletes without affective symptoms. Conclusions Athletes endorsing co-occurring depression/anxiety symptoms 24-48 hrs post-concussion were at significantly increased risk for prolonged recovery, though depression alone and anxiety alone did not convey the same risk. Findings suggest differential risk associated with affective symptom presentation; athletes endorsing elevated depression and anxiety symptoms in the acute phase of injury may benefit from targeted treatment to manage these symptoms, possibly reducing risk for complicated recovery.