672 FO69 – Preventing mental illness and suicidality as secondary sequelae of sport-related concussion in adolescents

Background Secondary sequelae of sport-related concussion (SRC) among adolescents may include development of depression or suicidality. Prevention strategies for these secondary sequelae are poorly understood. Objective (1) Cross-sectionally investigate associations between recent (≤12-months) concussion and endorsement of sadness/hopelessness or suicidal ideation/attempt; (2) Identify relationships between regular physical activity (PA) and endorsement of sadness/hopelessness or suicidal ideation/attempt among adolescents with recent concussion. Design A nationwide survey, administered using a multi-stage cluster random sampling design, targeted all adolescents enrolled in public or private schools within one country. Setting Participants completed the survey via an online platform in early 2021. Participants 12–18-year-olds. Assessment of Risk Factors Self-reported concussions sustained during sports (none vs. ≥ one) and days per week of PA for more than 60 total minutes (≤3days/week vs. >3days/week) over the previous 12-months. Main Outcome Measures Self-reported sadness/hopelessness (yes/no), seriously considering suicide (yes/no), or attempting suicide (yes/no) over the previous 12-months. Results 7,692 participants (Table) completed the survey, of which 728 (10.1%) sustained SRC in the previous year. Participants with recent concussion had 1.29-times (95% Confidence Interval [CI]: 1.08–1.54; p=.007) greater odds of endorsing sadness/hopelessness, 1.64-times (CI: 1.27–2.11; p<.001) greater odds of considering suicide, and 2.93-times (CI: 2.06–4.17; p<.001) greater odds of attempting suicide compared to participants without recent concussion. Among the subset of individuals who sustained recent concussion (N=728), for those who reported PA >3days/week, the odds of endorsing sadness/hopelessness, suicidal ideation, or suicide attempt were 0.51-times (CI: 0.34–0.76; p=.001), 0.63-times (CI: 0.41–0.98; p=.04), and 0.90-times (CI: 0.69–1.39; p=.64) that of individuals with recent concussion who were not physically active (Figure). Conclusions Adolescents with recent concussion are more likely than peers to report sadness/hopelessness and suicidal ideation/attempt. Our nationally representative cross-sectional investigation suggests that regular PA may mediate the relationship between mental illness development and concussion.