Anxiety and Mood Disruption in Collegiate Athletes Acutely Following Mild Traumatic Brain Injury

Objective: To report the symptom burden of anxiety and mood-related indicators following mTBI in collegiate student-athletes. Study Design: Retrospective cohort study of varsity collegiate athletes. Setting: University sports medicine at a tertiary care center. Patients: Division I college varsity athletes diagnosed with mTBI at a single institution between 2016 and 2019. Independent Variables: Pre- and post-injury. Main Outcome Measures: Comparisons between baseline testing and post-mTBI symptom scale assessments were made to determine changes in scores at the individual and group levels. The primary outcome was the prevalence of post-mTBI symptoms from within 72 h of injury through return to play. Associations with sport, sex, age, and return-to-play time were included. Results: Compared to baseline, mood and anxiety symptom scores were significantly higher acutely following mTBI (2.1 +/- 3.3 vs. 14.3 +/- 12.2; p < 0.001). A family history of migraine was significantly associated with higher mood and anxiety symptom scores (20.0 +/- 14.9 with history vs. 13.3 +/- 11.3 without history; p = 0.042). Mood and anxiety symptom scores were highly correlated with non-mood and anxiety symptom scores for all athletes, including the subgroup with prolonged symptoms (r = 0.769; p < 0.001). Conclusions: Symptoms of anxiety or mood disruption are common during the acute period post-injury in varsity college athletes. Risk factors for higher symptom reports immediately following mTBI and for prolonged symptoms (>10 days) included female sex, those with a family history of migraine, and those with an overall higher symptom burden post-injury.