{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T01:52:59Z","timestamp":1788745979061,"version":"build-2803163510"},"reference-count":51,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2021,1,29]],"date-time":"2021-01-29T00:00:00Z","timestamp":1611878400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2021,1,29]],"date-time":"2021-01-29T00:00:00Z","timestamp":1611878400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:p>\n                    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\u2013BREF (WHOQOL-BREF) were sent to 526 adult patients diagnosed with PCS. Median with interquartile range follow-up time was 5 (4\u20137) 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 (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.030) and Depression (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.018) 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 (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.001) 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.\n                  <\/jats:p>","DOI":"10.1089\/neu.2020.7313","type":"journal-article","created":{"date-parts":[[2020,9,23]],"date-time":"2020-09-23T02:57:07Z","timestamp":1600829827000},"page":"493-505","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":58,"title":["Anxiety, Depression, and Quality of Life: A Long-Term Follow-Up Study of Patients with Persisting Concussion Symptoms"],"prefix":"10.1177","volume":"38","author":[{"given":"Corinne","family":"Doroszkiewicz","sequence":"first","affiliation":[{"name":"Canadian Concussion Center, Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Gold","sequence":"additional","affiliation":[{"name":"Neuropsychology Clinic, Krembil Neuroscience Network, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin","family":"Green","sequence":"additional","affiliation":[{"name":"Canadian Concussion Center, Toronto, Ontario, Canada."},{"name":"Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Carmela","family":"Tartaglia","sequence":"additional","affiliation":[{"name":"Canadian Concussion Center, Toronto, Ontario, Canada."},{"name":"Division of Neurology, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Ma","sequence":"additional","affiliation":[{"name":"Biostatistics Research Unit, University Health Network, Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles H.","family":"Tator","sequence":"additional","affiliation":[{"name":"Canadian Concussion Center, Toronto, Ontario, Canada."},{"name":"Division of Neurosurgery, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,1,29]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.3171\/2015.6.JNS15664"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2016.4677"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2017-097729"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.yco.0000165601.29047.ae"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2001.tb00208.x"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1249\/JSR.0b013e3181ccb55e"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/YCO.0b013e328344698b"},{"key":"e_1_3_4_9_2","volume-title":"ICD-10 Classification of Mental and Behavioral Disorders: Clinical Descriptions and Diagnostic Guidelines","author":"World Health Organization","year":"1992","unstructured":"World Health Organization. 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