title: Prevalence of diagnosed depression in adolescents with history of concussion.
abstract: OBJECTIVE
  Previous studies in adults have suggested concussion and other brain injury presents a risk factor for depression. The goal of our study was to analyze the association between previous concussion and current depression diagnosis in a large nationally representative adolescent data set.
  
  
  METHODS
  Retrospective cohort study using the National Survey of Children's Health 2007-2008, a nationally representative survey conducted via random digit dialing. Data were obtained by parental report. We included youth 12-17 years old without a current concussion (N = 36,060), and evaluated the association between previous concussion (binary) and current depression diagnosis (binary) using multiple logistic regression to control for age, sex, parental mental health, and socioeconomic status.
  
  
  RESULTS
  After controlling for age, sex, parental mental health, and socioeconomic status, history of concussion was associated with a 3.3-fold greater risk for depression diagnosis (95% CI: 2.0-5.5). Other factors significantly associated with depression diagnosis included poor or fair parental mental health (OR: 3.7, 95% CI: 2.8-4.9), and older age (15-17 years vs. 12-14 years, OR: 1.4, 95% CI: 1.1-1.8). Sex of the subject was not significantly related to depression diagnosis. Being above 200% of the poverty level was associated with approximately a 50% decreased risk of depression diagnosis (95% CI: 35%-70%).
  
  
  CONCLUSIONS
  History of concussion was associated with a higher prevalence of diagnosed depression in a large nationally representative adolescent data set. Clinicians should screen for depression in their adolescent patients with concussion. Future studies should confirm this association using prospective methodology and examine potential treatment approaches.
authors.affiliation: Division of Adolescent Medicine, Department of Pediatrics, University of Washington, Seattle, Washington; Seattle Children's Hospital, Center for Child Health Behavior and Development, Seattle, Washington. Electronic address: sara.chrisman@seattlechildrens.org.
authors.forename: Sara P D
authors.initials: SP
authors.lastname: Chrisman
authors.affiliation: Division of Adolescent Medicine, Department of Pediatrics, University of Washington, Seattle, Washington; Seattle Children's Hospital, Center for Child Health Behavior and Development, Seattle, Washington.
authors.forename: Laura P
authors.initials: LP
authors.lastname: Richardson
mesh_terms: D000293:Adolescent; D015331:Cohort Studies; D015897:Comorbidity; D016001:Confidence Intervals; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006261:Headache / Q000453:epidemiology; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D038223:Post-Concussion Syndrome / Q000453:epidemiology*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
keywords: Adolescents; Concussion; Depression; Traumatic brain injury