Adolescent Concussion and Mental Health Outcomes: A Population-based Study.

Objectives: Population-based research on the relationship between concussions and self-harm, depression, and suicidal behaviors among adolescents is limited. Methods: A statewide Youth Risk Behavior Surveillance Survey (YRBSS) was conducted among students from 98 high schools in Nevada in 2017. Students were asked if they had a concussion from playing a sport as well as their mental health outcomes 12 months before the survey. Weighted multiple logistic regression was used to assess the relationship between experiencing a concussion and adverse mental health outcomes. Results: Among 3427 students who were physically active at least 60 minutes per day on 5 or more days per week, or played on at least one sport team, 19.5% (95% CI: 17.31%-21.60%) reported they had a concussion during the past 12 months. After controlling for sex, age, race/ethnicity, and academic performance, students who had a concussion had higher odds of: self-harm [aOR = 1.59 (1.16-2.17), p = .003], depressive symptoms [aOR = 1.48 (1.12-1.94), p = .006], attempted suicide [aOR = 3.10 (2.12-4.53), p < .001] and injury from attempted suicide [aOR = 2.61 (1.31-5.20, p = .006]. Conclusions: Students who experience a concussion may be at increased risk for poor mental health outcomes, including suicide attempts. Psychological evaluation following a concussion should complement medical evaluation and treatment..