Concussion-like symptom reporting in non-concussed adolescent athletes

Objective: The primary goals of this study were (1) to report rates of concussion-like symptoms in healthy adolescent student athletes assessed using the Sport Concussion Assessment Tool, 3rd edition (SCAT3) at baseline, (2) to examine rates of psychiatric diagnoses in this population, and (3) to evaluate effects of baseline symptoms on SCAT3 cognitive and balance performance. Methods: 349 adolescent student athletes (245 male) were administered the SCAT3 during pre-participation physical examinations. We described the prevalence rate of student athletes meeting criteria for International Classification of Diseases, 10th revision, post-concussional syndrome (ICD-10 PCS) diagnosis at baseline, and evaluated associations between symptom reporting and demographic/medical history factors using chi-square tests. Rates of self-reported psychiatric diagnosis were compared to general population estimates with one-sample binomial tests. We also compared SCAT3 cognitive and balance performance between adolescents with and without baseline ICD-10 PCS symptoms. Results: Overall, 20.3% of participants met ICD-10 PCS criteria at baseline. Rates were similar across sexes and age groups. We found no statistical association with medical history factors. The proportion of student athletes reporting a history of psychiatric diagnosis (5.2%) was significantly lower than general population estimates (14.0%; p<.001), and this effect was consistent across sexes and age groups. SCAT3 cognitive and balance performance did not differ based on baseline symptom reporting. Conclusions: Healthy adolescent student athletes frequently report concussion-like symptoms at baseline. Clinicians should factor pre-injury symptomatology and medical history into concussion management when determining symptom etiology throughout the course of recovery.