Documenting the Frequency and Burden of Symptom-Based Anxiety Disorders During Concussion Recovery

Purpose Characterize the frequency of symptom-based anxiety disorders in adults with concussion and describe anxiety burden across recovery phases. Method 88 adults (M=27.67, SD=6.41 yrs; 63% female) presenting for their first clinical concussion evaluation completed the Screen for Adult Anxiety Related Disorders (SCAARED) to assess panic disorder/significant somatic symptoms (PD/SSS), generalized anxiety (GAD), separation anxiety (SAD), and social phobia (SOC). Established cutoffs were used to indicate potential endorsement of disorders. Participants were grouped by timing of clinical presentation following injury (acute: 1-7 days post-injury, subacute: 8-30, and chronic: 31-90) (i.e., recovery phases). To characterize anxiety burden, the number of endorsed disorders for each participant was categorized as: no anxiety (0 disorders), 1 disorder, 2 disorders, and 3+ disorders. Descriptive statistics examined distributions across recovery phases. Results The most frequently endorsed anxiety disorder was PD/SSS (82%), and SAD was endorsed the least (36%). All participants seeking care in the acute phase (n=6) had at least 1 disorder, but the majority met criteria for either 2- (50%) or 3+ disorders (33%). Anxiety burden was more evenly distributed within the sub-acute phase (n=56) (0: 9%; 1: 16%; 2: 36%; 3+: 39%). However, anxiety burden appeared to be higher in the chronic phase (n=26), with 62% endorsing 3+ disorders, 23% reporting no anxiety, and few endorsing 1- (12%) or 2- (4%) disorders. Conclusions Symptom-based anxiety disorders are commonly endorsed in adults with concussion, particularly for patients in the acute and chronic phases of recovery. Findings highlight the value of comprehensive anxiety assessments throughout recovery.