The Relationship Between Sociodemographic Factors and Mental Health Outcomes in Adolescents After a Sport-Related Concussion

Context Sport-related concussion (SRC) is a growing public health concern in adolescents, with recovery influenced not only by physical symptoms but also by cognitive and emotional disturbances such as anxiety and depression. However, sociodemographic factors, particularly race and household income, may further affect recovery outcomes. Objective To examine mental health outcomes, specifically anxiety and depression, for adolescent patients diagnosed with an SRC in relation to sociodemographic factors. Design Cross-sectional retrospective chart review. Setting Specialty concussion clinic. Patients or Other Participants Four hundred sixty-four adolescents (mean = 14 ± 2 years; White = 233, 50.2%; person of color = 231, 49.8%) diagnosed with an SRC. Main Outcome Measure(s) Participants and their caregivers completed demographic and health history questionnaires, the Rivermead Post-Concussion Symptoms Questionnaire (RPQ), and the Beck Youth Inventory subscales for anxiety and depression. Descriptive statistics, t tests and Wilcoxon tests, correlation analyses, and linear regressions were performed. Results The mean RPQ score was 16.5 ± 13.3. A negative, nonsignificant association was found for race and household income with the RPQ score, respectively (β = −1.39, P = .3124; β = −0.52, P = .2756). Together, race and income explained only 0.5% of RPQ variation. Anxiety (8.3 ± 8.9) and depression (6.0 ± 7.8) scores were mild to moderate. We identified a moderate, significant, positive correlation for RPQ scores with anxiety ( r = 0.40, P < .0001) and depression ( r = 0.54, P < .0001). Spearman correlation indicated that household income was not found to be significantly related to depression ( r = −0.03, P = .5668) or anxiety ( r = 0.03, P = .4923) symptoms. A positive, nonsignificant association was found for race and household income with anxiety (race: β = 2.92, P = .120; income: β = 0.61, P = .3465) and for depression (race: β = −0.89, P = .3271; income: β = −0.22, P = .4840). Conclusions Pediatric patients with an SRC reported modest postconcussion symptoms and mild-to-moderate mental health symptoms. Higher postconcussion symptom scores were linked with higher anxiety and depression levels, suggesting these symptoms tend to occur together. In contrast, a patient’s race or household income was not a determinant of concussion symptomology or mental health outcomes.