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Cited by 282Traumatic Brain Injury ResearchSports injuries and preventionCOVID-19 and Mental Health

The DOI matches its Crossref record; 44 of the 44 references it cites were found in a registry or an index.

Nine-Year Risk of Depression Diagnosis Increases With Increasing Self-Reported Concussions in Retired Professional Football Players

Kerr, Zachary Y., Marshall, Stephen W., Harding, Herndon P., Guskiewicz, Kevin M.·2012·The American Journal of Sports Medicine
DOI 10.1177/0363546512456193
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Abstract

BACKGROUND: Concussions may accelerate the progression to long-term mental health outcomes such as depression in athletes. PURPOSE: To prospectively determine the effects of recurrent concussions on the clinical diagnosis of depression in a group of retired football players. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: Members of the National Football League Retired Players Association responded to a baseline General Health Survey (GHS) in 2001. They also completed a follow-up survey in 2010. Both surveys asked about demographic information, number of concussions sustained during their professional football career, physical/mental health, and prevalence of diagnosed medical conditions. A physical component summary (Short Form 36 Measurement Model for Functional Assessment of Health and Well-Being [SF-36 PCS]) was calculated from responses for physical health. The main exposure, the history of concussions during the professional playing career (self-report recalled in 2010), was stratified into 5 categories: 0 (referent), 1 to 2, 3 to 4, 5 to 9, and 10+ concussions. The main outcome was a clinical diagnosis of depression between the baseline and follow-up GHS. Classic tabular methods computed crude risk ratios. Binomial regression with a Poisson residual and robust variance estimation to stabilize the fitting algorithm estimated adjusted risk ratios. χ(2) analyses identified associations and trends between concussion history and the 9-year risk of a depression diagnosis. RESULTS: Of the 1044 respondents with complete data from the baseline and follow-up GHS, 106 (10.2%) reported being clinically diagnosed as depressed between the baseline and follow-up GHS. Approximately 65% of all respondents self-reported sustaining at least 1 concussion during their professional careers. The 9-year risk of a depression diagnosis increased with an increasing number of self-reported concussions, ranging from 3.0% in the "no concussions" group to 26.8% in the "10+" group (linear trend: P < .001). A strong dose-response relationship was observed even after controlling for confounders (years retired from professional football and 2001 SF-36 PCS). Retired athletes with a depression diagnosis also had a lower SF-36 PCS before diagnosis. The association between concussions and depression was independent of the relationship between decreased physical health and depression. CONCLUSION: Professional football players self-reporting concussions are at greater risk for having depressive episodes later in life compared with those retired players self-reporting no concussions.

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Crossref · 10.1177/0363546512456193

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Citations

Cites

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Research works printed but not linked: 6

  1. Gessel LM, 2007, J Athl Train, 42, 495
  2. Hoge CW, 2011, N Engl J Med, 365, 860
  3. Nauta WJ, 1972, Acta Neurobiol Exp (Wars), 32, 125
  4. Register-Mihalik J, 2011, 2011 National Athletic Trainers’ Association Annual Meeting and Clinical Symposium, 46, S16
  5. Register-Mihalik J, 2010, 2010 National Athletic Trainers’ Association Annual Meeting and Clinical Symposium, 45, S19
  6. Rothman KJ, 2008, Modern Epidemiology

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Metadata

Authors
Kerr, Z. Y., Marshall, S. W., Harding, H. P., & Guskiewicz, K. M.
Affiliations
  • University of North Carolina at Chapel Hill (US)
  • Florida State University (US)
ORCID
Venue
The American Journal of Sports Medicine
Publisher
SAGE Publications
Published
2012-08-24
Volume
40
Issue
10
Pages
2206-2212
ISSN
  • 0363-5465 (ISSN-L)
  • 1552-3365
DOI
10.1177/0363546512456193
OpenAlex
W1983025973
Cited by
282
References
44
Citations by year
2026: 11 · 2025: 4 · 2024: 15 · 2023: 19 · 2022: 13 · 2021: 37 · 2020: 27 · 2019: 25 · 2018: 25 · 2017: 27 · 2016: 23 · 2015: 29 · 2014: 13 · 2013: 11 · 2012: 3
FWCI
13.30
Type
journal article
Language
en
Open access
closed
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • The American Journal of Sports Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Football League Players Association
  • Brain Injury Research Center
Topics
  • Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury Research
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports injuries and prevention
  • Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
Keywords
depression, concussion, recurrent concussion, National Football League, long-term mental health outcomes, dose-response relationship, physical health, physical component summary, SF-36, sports-related brain injury
MeSH terms
Athletic Injuries, Brain Concussion, Depression, Follow-Up Studies, Football, Humans, Male, Prospective Studies, Recurrence, Retirement, Risk Factors, Self Report

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