Persisting concussion symptoms (PCS) can last for months, years, or indefinitely and affect a considerable number of concussion patients. The objectives of this study were to evaluate the prevalence of clinical symptoms of anxiety and depression and the relationship between PCS and quality of life in patients examined at the Canadian Concussion Centre. The Depression and Anxiety Stress Scale-42 (DASS-42) and the World Health Organization Quality of Life Assessment–BREF (WHOQOL-BREF) were sent to 526 adult patients diagnosed with PCS. Median with interquartile range follow-up time was 5 (4–7) years. Of the 105 respondents, 35.2% displayed mild or greater symptoms of anxiety, depression, or both. Importantly, the number of previous concussions was correlated with elevations on the DASS-42 Anxiety (p = 0.030) and Depression (p = 0.018) subscale scores, suggesting an acquired cause of symptoms. Patients with clinical elevations of depression, anxiety, or both exhibited poorer mean WHOQOL-BREF scores in each domain (p < 0.001) compared to those who scored in the normal range on the DASS-42. These findings indicate that depression and anxiety in PCS can endure for years and are associated with diminished quality of life. Consequently, depression and anxiety should be identified and treated early in PCS populations in order to optimize recovery. Although the underlying etiology of depression and anxiety cannot be ascertained with certainty in the present study, the association between depression and anxiety and the number of concussions may indicate an organic explanation. In the future, quality-of-life measures should be incorporated into treatment and research in PCS to improve intervention strategies and enhance understanding of the trajectory of recovery in this population.

中文翻译：

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焦虑、抑郁和生活质量：对持续脑震荡症状患者的长期随访研究

持续性脑震荡症状 (PCS) 可持续数月、数年或无限期，并影响相当多的脑震荡患者。本研究的目的是评估在加拿大脑震荡中心接受检查的患者的焦虑和抑郁临床症状的患病率以及 PCS 与生活质量之间的关系。抑郁和焦虑压力量表-42 (DASS-42) 和世界卫生组织生活质量评估-BREF (WHOQOL-BREF) 发送给 526 名诊断为 PCS 的成年患者。四分位距随访时间的中位数为 5 (4-7) 年。在 105 名受访者中，35.2% 的人表现出轻微或更大的焦虑、抑郁或两者兼有的症状。重要的是，先前脑震荡的次数与 DASS-42 焦虑 ( p = 0.030) 和抑郁 ( p  = 0.018) 分量表得分，表明症状的获得性原因。临床抑郁、焦虑或两者同时升高的患者在每个领域的平均 WHOQOL-BREF 得分较低（p <0.001) 与在 DASS-42 上得分在正常范围内的人相比。这些发现表明，PCS 中的抑郁和焦虑可以持续数年，并且与生活质量下降有关。因此，应在 PCS 人群中及早识别和治疗抑郁和焦虑，以优化康复。尽管在本研究中无法确定抑郁和焦虑的潜在病因，但抑郁和焦虑与脑震荡次数之间的关联可能表明了一种有机的解释。未来，应将生活质量措施纳入 PCS 的治疗和研究，以改进干预策略并增强对该人群康复轨迹的了解。