{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T13:20:17Z","timestamp":1788441617560,"version":"build-2803163510"},"reference-count":45,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"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":["J Child Neurol"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:p>\n                    This secondary analysis examined the association between preexisting mental health conditions and clinical recovery trajectories in adolescents with concussion. Adolescents (13-17; n\u2009=\u20091238) completed clinical assessments (Post-Concussion Symptom Inventory [PCSI] \u226448 hours postinjury; PCSI\/ Pediatric Quality of Life [PedsQL] for 3 months) and were categorized into control, anxiety, depression, or combined anxiety\/depression groups. Acute outcomes were analyzed using analysis of variance or \u03c7\n                    <jats:sup>2<\/jats:sup>\n                    , whereas linear and logistic regression analyzed recovery trajectories. A main effect of group was present for acute symptom scores (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u2009.03), but post-hoc testing revealed no significant comparisons. Main effects of group and time were observed for PCSI and PedsQL outcomes (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009&lt;\u2009.007), but interaction effects were nonsignificant. The combined anxiety\/depression group reported more symptoms, worse quality of life, and had greater odds of experiencing persistent postconcussion symptoms (defined as \u22653 new\/worse symptoms at 4 weeks; OR = 2.31, 95% CI\u2009=\u20091.18-4.67,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u2009.02) in univariate models. However, multivariable models found no association between preexisting mental health conditions and the presence of PPCS (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u2009.62). Preexisting mental health conditions were associated with similar longitudinal trajectories but higher symptom and lower quality of life scores overall, highlighting their importance in adolescent concussion management.\n                  <\/jats:p>","DOI":"10.1177\/08830738251408113","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T18:18:43Z","timestamp":1767896323000},"page":"1249-1259","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Preexisting Mental Health Disorders Are Associated With Acute Clinical Presentation and Longitudinal Recovery Trajectories in Adolescents With Concussion"],"prefix":"10.1177","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-8313-0861","authenticated-orcid":false,"given":"Sofia G","family":"Iuliano","sequence":"first","affiliation":[{"name":"Concordia University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2043-1644","authenticated-orcid":false,"given":"Isabelle J","family":"Gagnon","sequence":"additional","affiliation":[{"name":"McGill University"},{"name":"Montreal Children's Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grant L","family":"Iverson","sequence":"additional","affiliation":[{"name":"Harvard Medical School"},{"name":"Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA, USA"},{"name":"Mass General for Children Sports Concussion Program, Waltham, MA, USA"},{"name":"Department of Physical Medicine and Rehabilitation, Schoen Adams Research Institute at Spaulding Rehabilitation, Charlestown, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1946-9023","authenticated-orcid":false,"given":"Nathan E","family":"Cook","sequence":"additional","affiliation":[{"name":"University of Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7807-2459","authenticated-orcid":false,"given":"Roger","family":"Zemek","sequence":"additional","affiliation":[{"name":"University of Ottawa"},{"name":"Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2846-5884","authenticated-orcid":false,"given":"Elizabeth F","family":"Teel","sequence":"additional","affiliation":[{"name":"Concordia University"},{"name":"Concordia 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