College Athletes with ADHD Are at Higher Risk of Depression and Anxiety after Concussion
College athletes with attention deficit hyperactivity disorder (ADHD)—a childhood disorder frequently diagnosed in young adults and characterized by impulsivity and problems concentrating that interfere with functioning or development—had a higher risk of developing depression and anxiety after a concussion than those without ADHD. That’s according to a preliminary study presented at the American Academy of Neurology (AAN) Sports Concussion Conference, in Indianapolis.
ADHD, Concussion, and Mental Health
To examine the effects of concussion on mental health in players with ADHD, researchers evaluated 979 NCAA Division 1 athletes at the University of South Carolina, as part of a larger athlete performance health and wellness program.
Researchers divided the athletes into four groups: those with ADHD who also had sustained concussion (33); those with ADHD and no concussion history (81); those with a past concussion and no ADHD (82); and those who neither had ADHD nor had sustained a concussion (787).
Athletes completed an anxiety questionnaire that asked how often they agreed with statements such as "I am tense; I am worried" and "I worry too much over something that really doesn't matter." Answers ranged from "Almost never" to "Almost always;" scores ranged from 20 to 80 with the higher score correlating with more anxiety.
In addition, athletes also completed a depression questionnaire, which asked how often during the past week they agreed with statements such as "I did not feel like eating; my appetite was poor" and "I felt that everything I did was an effort." Answers ranged from "Rarely or none of the time (less than 1 day)" to "Most or all of the time (5 to 7 days);" scores ranged from 0 to 60. Scores of 16 or higher indicated a risk for clinical depression.
Athletes with ADHD Reported More Anxiety and Depression Post-Concussion
Athletes who had ADHD and sustained a concussion scored higher on questionnaires that measured depression and anxiety. On average, the ADHD and concussion group's depression score was 25.5, compared to 16.3 in the other three groups. Those with ADHD and concussion scored 42.1 on the anxiety scale, compared to 33.4 in the other groups.
Meanwhile, athletes with ADHD and no history of concussion showed no increase in anxiety or depression.
Depression and Anxiety Linger Longer in Athletes with ADHD
All athletes were evaluated six months after their initial concussion. Among players with ADHD, the differences in test scores for anxiety and depression persisted for weeks after the initial injury.
Although the scores of athletes with ADHD and concussion were higher than the other groups, they were not in the range of clinical depression or anxiety.
ADHD Athletes Need Extra Care
"Athletes with ADHD should receive extra care and monitoring, as they will likely experience more severe symptoms after a concussion than others," the researchers concluded.
More Research Is Needed
The current study does not prove a cause-and-effect relationship, and it warrants further research using multiple tests before and after sustaining a concussion to see if athletes with ADHD are more susceptible to anxiety and depression post-concussion.