The study was based on data collected during the 2007-2008 portion of the National Survey of Children's Health 2007,  a random telephone survey of parents with one or more children under 18 years old administered by the Maternal and Child Health Bureau of U.S. Department of Health and Human Services. If respondents reported no children under 18 years old lived in the household, the interview was stopped. If they reported children under age 18, one of the children was randomly selected to be discussed.
The interview was conducted with the parent or caregiver, and interviews were completed in 66% of households identified with children, for a total of 91,642 surveys. Surveys were conducted in English and Spanish. The survey was designed to collect a nationally representative sample of the noninstitutionalized population aged 0-17 years, with at least 1,700 surveys per state. A wide range of topics were covered including (1) medical insurance coverage; (2) child and family demographics; (3) parental physical and mental health; (4) child physical and mental health; (5) school performance; and (6) neighborhood description.
Data from 36,060 individuals met the criteria for analysis; of these 49.2% were female (Table 1). A small proportion of these subjects had had a previous concussion (2.7%) and a similarly small number had a current depression diagnosis (3.4%). There were slightly more males than females (50.8% vs. 49.2%) and slightly more younger adolescents than older adolescents (50.8% vs. 49.2%). Few of these subjects (10.7%) had parents with poor or fair mental health and it was uncommon (15.2%) for subjects to be at or below the poverty level.
The researchers found that:
- History of concussion was associated with a 3.2-fold greater risk for current depression compared with those with no such history.
- Being an older adolescent (15-17 years) was associated with 1.5-fold greater risk for depression compared with being a younger adolescent (12-14 years).
- Poor or fair mental health of either parent was associated with a 4.8-fold greater risk for depression compared with parental mental health rated as good, very good, or excellent.
- Being above the poverty level was associated with a 33%-64% decreased risk for depression compared with being at or below the poverty level.
- Although there were more females than males who were depressed, a subject's sex was not significantly associated with depression diagnosis.
1. Chrisman SPD, Richardson LP. Prevalence of Diagnosed Depression in Adolescents With History of Concussion. J Adolescent Health. 2013; doi:10.1016/j.jadohealth.2013.10.006, epub December 17, 2013. accessed January 3, 2014
2. Harmon KG, Drezner JA, Gammons M, et al. American Medical Society for Sports Medicine Position Statement: Concussion in Sport. Br J Sports Med. 2013;47:15-26
3. Witvliet M, Brendgen M, van Lier PA, et al. Early adolescent depressive symptoms: Prediction from clique isolation, loneliness, and perceived social acceptance. J Abnorm Child Psychol. 2010;38:1045-1056
4. Teychenne M, Ball K, Salmon J. Sedentary behavior and depression among adults: A review. Int J Behav Med. 2010;17:246-254
5. Schneider KJ, Iverson GL, Emery CA, et al. The effects of rest and treatment following sport-related concussion: A systematic review of the literature. Br J Sports Med. 2013;47:304-307
6. Andelic N, Bautz-Holter E, Ronning P, et al. Does an early onset and continuous chain of rehabilitation improve the long-term functional outcome of patients with severe traumatic brain injury?. J Neurotrauma. 2012;29:66-74
7. Silverberg ND, Iverson GL. Is rest after concussion "the best medicine?": Recommendations for activity resumption following concussion in athletes, civilians, and military service members. J Head Trauma Rehabil. 2013;28:250-259.
8. Fletcher JM. Adolescent depression: Diagnosis, treatment, and educational attainment. Health Econ. 2008;17:1215-1235
9. Richardson LP, Davis R, Poulton R, et al. A longitudinal evaluation of adolescent depression and adult obesity. Arch Pediatr Adolesc Med. 2003;157:739-745
10. Saluja G, Iachan R, Scheidt PC, et al. Prevalence of and risk factors for depressive symptoms among young adolescents. Arch Pediatr Adolesc Med. 2004;158:760-765
11. Lewinsohn PM, Hops H, Roberts RE, et al. Adolescent psychopathology: I. Prevalence and incidence of depression and other DSM-III-R disorders in high school students. J Abnorm Psychol. 1993;102:133-144
14. Meares S, Shores EA, Taylor AJ, et al. Mild traumatic brain injury does not predict acute postconcussion syndrome. J Neurol Neurosurg Psychiatry. 2008;79:300-306
15. Holsinger T, Steffens DC, Phillips C, et al. Head injury in early adulthood and the lifetime risk of depression. Arch Gen Psychiatry. 2002;59:17-22
16. Guskiewicz KM, Marshall SW, Bailes J, et al. Recurrent concussion and risk of depression in retired professional football players. Med Sci Sports Exerc. 2007;39:903-909
17. Fann JR, Burlington B, Leonetti A, et al. Psychiatric illness following traumatic brain injury in an adult health maintenance organization population. Arch Gen Psychiatry. 2004;61:53-61
18. Max JE, Keatley E, Wilde EA, et al. Depression in children and adolescents in the first 6 months after traumatic brain injury. Int J Dev Neurosci. 2012;30:239-245
19. Massagli TL, Fann JR, Burington BE, et al. Psychiatric illness after mild traumatic brain injury in children. Arch Phys Med Rehabil. 2004;85:1428-1434
20. Zatzick DF, Grossman DC. Association between traumatic injury and psychiatric disorders and medication prescription to youths aged 10-19. Psychiatr Serv. 2011;62:264-271
21. O'Connor SS, Zatzick DF, Wang J, et al. Association between posttraumatic stress, depression, and functional impairments in adolescents 24 months after traumatic brain injury. J Trauma Stress. 2012;25:264-271
22. Child and Adolescent Health Measurement Initiative (CAHMI), 2007, National Survey of Children's Health Indicator Data Set, Data Resource Center for Child and Adolescent Health, Available at: www.childhealthdata.org.
23. Schatz P, Moser RS, Covassin T, Karpf R. Early Indicators of Enduring Symptoms in High School Athletes with Multiple Previous Concussions. Neurosurgery 2011;68:1562-1567.
24. Moser RS, Glatts C, Schatz P. Efficacy of Immediate and Delayed Cognitive and Physical Rest for Treatment of Sport-Related Concussion. J Pediatrics 2012;161(5):922-926.
25. Katherine Kahn. "Teen Concussions Increase Risk for Depression." Health Behavior News Service. January 9, 2014, http://www.newswise.com/articles/teen-concussions-increase-risk-for-depression?ret=/articles/list&category=medicine&page=1&search%5Bstatus%5D=3&search%5Bsort%5D=date+desc&search%5Bsection%5D=10&search%5Bhas_multimedia%5D=