190 Concussions among female athletes in Iceland: stress, depression, anxiety and quality of life

Background Studies have shown mental distress in male athletes with self-reported concussions. Female athletes may have more persistent symptoms following concussions but studies on female mental outcomes are lacking. Objective To examine the relationship between self-reported concussions and stress, depression, anxiety and quality of life among female athletes. Design An online questionnaire was distributed through sports-related Facebook pages (snowball sampling) to females in high-concussion risk sports. Participants answered background questions and mental health questionnaires. They reported the total number of sustained concussions after reading a definition of a concussion. The study was approved by the National Bioethics Committee. Setting The questionnaire was sent out by an academic research group (Reykjavik University) to former and current female athletes (18–45 years), in high-concussion risk sports. Patients (or Participants) 508 Icelandic female athletes (M=26.9, SD=7.1) currently or previously training and competing in the two top leagues in basketball, soccer and handball, in the top league in ice-hockey and in national tournaments in martial arts. Participants signed an electronic informed consent. Interventions (or assessment of risk factors) Independent variable: Number of self-reported concussions. Main outcome measurements Perceived Stress scale (PSS), Patient Health Questionnaire (PHQ-9), General Anxiety Disorder Questionnaire (GAD-7), and Quality of Life Scale (QOLS). Results Female athletes with a history of one or more concussions scored significantly higher on PHQ-9, PSS and GAD-7 than those reporting no concussions. The QOLS did not differ between the groups. Concussed athletes were 3.9 times more likely to score above clinical cut-off on PHQ-9 and 2.3 times more likely to score above clinical cut-off on GAD-7 than those with no concussions. Number of concussions predicted scores on PSS, PHQ-9, GAD-7 and QOLS. Conclusions Female athletes with a history of concussion have worse mental health than those with no history of concussion. The higher number of concussions sustained, the worse they feel.