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Depression and sports-related concussion: A systematic review - 23/11/17

Doi : 10.1016/j.lpm.2017.08.013 
Antoine Yrondi 1, 2, 3, , David Brauge 3, 4, Johanne LeMen 3, 5, Christophe Arbus 1, 2, 3, J??r??mie Pariente 2, 3, 5
1 CHU Toulouse-Purpan, Psychiatry and medical psychology department, 330, avenue de Grande-Bretagne, 31059 Toulouse, France 
2 UPS, Universit?? de Toulouse, TONIC, Toulouse NeuroImaging Center, 31024 Toulouse cedex 3, France 
3 CHU Toulouse, Federation Hospitalo-Universitaire, Cognitive, Psychiatric and Sensory Disabilities, 31059 Toulouse, France 
4 CHU Toulouse-Purpan, Neurosurgery department, 31059 Toulouse, France 
5 CHU Toulouse-Purpan, Neurology department, 31059 Toulouse, France 

???Antoine Yrondi, CHU Toulouse-Purpan, Psychiatry and medical psychology department, 330, avenue de Grande Bretagne 31059 Toulouse, France.

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Summary

Context

Head injuries are risk factors for chronic depressive disorders, but this association remains poorly explored with regards to concussion.

Objectives

The objective of this review was to evaluate the incidence of depressive symptoms and depression after sports-related concussion. We also endeavored to identify the response elements regarding the pathophysiology of these symptoms.

Methods

A systematic search of PubMed and Embase was conducted focusing on papers published until 1st December, 2016, according to PRISMA criteria The following MESH terms were used: (concussion or traumatic brain injury) and sport and (depression or depressive disorder).

Results

A depressive disorder can appear immediately after a concussion: depressive symptoms seem to be associated with the symptoms of the concussion itself. A depressive disorder can also appear later, and is often linked to the frequency and number of concussions. Furthermore, the existence of a mood disorder prior to a concussion can contribute to the onset of a depressive disorder after a concussion.

Limits

There is an overall limit concerning the definition of a depressive disorder. In addition, when these studies had controls, they were often compared to high-level athletes; yet, practicing sport regularly is a protective factor against mood pathologies.

Conclusions

Depressive symptoms after a concussion seem to be associated with postconcussion symptoms. Repeat concussions can contribute to later-onset major depressive disorders. However, playing sports can protect against major depressive disorders: thus, it is essential to evaluate concussions as accurately as possible.

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R??sum??

Contexte

Les traumatismes cr??niens sont des facteurs de risque de troubles d??pressifs chroniques, mais cette association reste peu explor??e en ce qui concerne la commotion c??r??brale dans le sport.

Objectifs

L???objectif de cette revue est d?????valuer l???incidence des sympt??mes d??pressifs et de la d??pression apr??s une commotion c??r??brale li??e au sport. Nous avons ??galement cherch?? ?? identifier les ??l??ments de r??ponse concernant la pathophysiologie de ces sympt??mes.

Sources documentaires

Une recherche syst??matique de PubMed et Embase a ??t?? men??e en se concentrant sur les articles publi??s jusqu???au 1er d??cembre 2016??selon les crit??res PRISMA. Les termes suivants de MESH ont ??t?? utilis??s??: (concussion or traumatic brain injury) and sport and (depression or depressive). Seuls les articles en anglais sont pris en compte. S??lection des ??tudes??: les 5??auteurs ont proc??d?? ?? une s??lection des titres des publications identifi??es dans les bases de donn??es gr??ce ?? la strat??gie de recherche d??finie plus haute afin d???identifier les ??tudes possiblement ??ligibles. Ces deux auteurs ont, d???abord de mani??re ind??pendante puis conjointe, s??lectionn?? les ??tudes sur la base des r??sum??s de celles-ci.

R??sultats

Un trouble d??pressif peut appara??tre imm??diatement apr??s une commotion c??r??brale: les sympt??mes d??pressifs semblent ??tre associ??s aux sympt??mes de la commotion c??r??brale elle-m??me. Un trouble d??pressif peut ??galement appara??tre plus tard, et est souvent li?? ?? la fr??quence et le nombre de commotions c??r??brales. En outre, l???existence d???un trouble de l???humeur avant une commotion c??r??brale peut contribuer ?? l???apparition d???un trouble d??pressif apr??s une commotion c??r??brale.

Limites

Il existe une limite globale concernant la d??finition d???un trouble d??pressif qui n???est que rarement d??fini. En outre, lorsque ces ??tudes ont eu des contr??les, elles ont souvent ??t?? compar??es ?? des athl??tes de haut niveau, mais la pratique r??guli??re du sport est un facteur de protection contre les pathologies de l???humeur.

Conclusions

Les sympt??mes d??pressifs apr??s une commotion c??r??brale semblent ??tre associ??s ?? des sympt??mes post-commotionels. Les commotions c??r??brales r??p??t??es peuvent contribuer ?? des troubles d??pressifs majeurs tardifs. Cependant, pratiquer des sports peut prot??ger contre les troubles d??pressifs majeurs: il est donc essentiel d?????valuer les commotions c??r??brales aussi pr??cis??ment que possible.

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Vol 46 - N° 10

P. 890-902 - Ottobre 2017 Ritorno al numero

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