Irritability and aggression in persistent youth concussions

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ObjectiveTo assess whether irritability and aggression are viable indicators of persistent post-concussive symptoms in adolescents.DesignGroup differences between those diagnosed with concussions were analysed using ANOVAs (p < 0.05).SettingOutpatient clinic.Participants46 concussed adolescents age 12–17 with persisting concussion symptoms were assessed. Athletes were split into two groups: those endorsing irritability/aggression (AGG, n=24) and a control group of those denying irritability/aggression (CON, n=22). Those with baseline psychiatric history and/or special education were excluded.Assessment of risk factorsPost-concussive symptom variable relationships were assessed.Outcome measuresgroup differences were analysed using ANOVAs.ResultsAdolescents endorsing irritability/aggression reported more fatigue (p=0.002), disordered sleep (p=0.001), anxiety (p=0.028), depression (p=0.003), and mood lability (p<0.001) during clinical assessment. Adolescents reporting more irritability also had elevated scores on related psychometric scales, including the Beck Youth Inventory-II Anxiety [t(41)=−2.916, p = 0.006], Depression [t(41)=−3.551, p = 0.001], and Anger Scales [t(41)=−2.958, p=0.005].ConclusionsResults indicate that adolescents with self-reported irritability and aggression post-concussion were more likely to display more affective symptoms than those who did not endorse irritability and aggression following concussions. They were also more likely to complain of fatigue and disordered sleep. These findings suggest that change in level of irritability/aggression could potentially serve as an identifiable indicator for parents and coaches to recognise when an adolescent is not recovering well post-concussion.Competing interestsNone.

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