Screening for Anxiety and Depression Symptoms Using Concussion Symptom Scales Among Varsity Athletes

Objective: This study examined associations between Sport Concussion Assessment Tool-5 (SCAT-5) symptom reporting and gold-standard measures of anxiety and depression, and explored the utility SCAT-5 symptom subscales to identify anxiety and depression symptomology. Design: Prospective cross-sectional study. Setting: York University in Toronto, Canada. Participants: Preseason data were collected for varsity athletes (N = 296) aged between 17 and 25 years (M = 20.01 years, SD = 1.69 years; 52% male). Main Outcome Measures: The SCAT-5 symptom evaluation scale was used to assess baseline symptoms. The Generalized Anxiety Disorder Index-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) were used to assess symptoms of anxiety and depression, respectively. Results: Endorsement of SCAT-5 symptoms of feeling anxious, sadness, irritability, and feeling more emotional had the strongest correlations with the GAD-7 (r's > 0.400; P's < 0.001). Sadness, trouble falling asleep, concentration problems, feeling slowed down, anxious, irritability, mental fog, fatigue, and memory problems had the highest correlations with the PHQ-9 (r's >0 .400; P's < 0.001). The Emotional subscale from the SCAT-5 predicted mild to severe anxiety on the GAD-7 (P < 0.001). The Sleep, Cognitive, and Emotional subscales predicted mild to severe depression on the PHQ-9 (P's < 0.05). Conclusions: These findings provide better delineation of symptoms endorsed on the SCAT-5 symptoms that aid in identification of athletes with symptoms of anxiety or depression who may be at risk for developing a clinical disorder or experiencing persistent symptoms after a concussion.