Objective Investigation of anxiety and depression symptoms at baseline and following sport related concussion in a population of professional and collegiate football players. Method A quasi-experimental prospective longitudinal design was implemented. Participants included 198 Canadian Football League and University of Alberta varsity football players at baseline. Additionally, this study tracked 13 concussed athletes, 12 orthopaedic control athletes, and 15 healthy control athletes over approximately a 2 month period. Statistical analysis included an ANOVA and repeated measures ANOVA to identify differences in mental health at baseline as well as after injury at 3 time points (24-48 hours post injury, asymptomatic, and 1 month post return to play). Results At baseline, players who had a history of 1 or more concussions reported a greater number of anxiety and depression symptoms in comparison to players who did not have a history of concussion (F(2, 197) = 66.75, (p =.000)). At the group level, there were no differences in anxiety and depression symptoms between players who sustained a concussion, orthoepic injury, or no injury across the four time points measured (depression (F(3, 58) = 1.05, (p =.404); anxiety (F(3, 58) = 1.65, (p =.151)). However, individuals who sustained a concussion displayed significant changes in symptoms of anxiety (F(3, 12) = 9.004, (p =.000)) and depression (F(3, 12) = 11.396, (p =.000)) over time. Specifically, concussed players reported an increase in anxiety related symptoms between baseline report and 24-48 hours post injury (p = .042), a decrease between 24-48 hours and 1 month post return to play (p = .002) and a decrease between asymptomatic and 1 month post return to play (p = .036) time points. Additionally, players who sustained a concussion reported a significant increase in depressive symptoms between 24-48 hours post injury and 1 month post return to play (p = .029) and a decrease between asymptomatic and 1 month post return to play (p = .014) time points. This change over time was not found in the orthopaedic injury (depression (F(3, 11) = 2.467, (p =.14); anxiety (F(3, 11) = 2.242, (p =.15)) or healthy control groups (depression; (F(3, 14) = 2.177, (p =.17); anxiety; F(3, 14) = 1.435, (p =.30)). Conclusions Results from this study suggest that a history of concussion impacts baseline self-report of anxiety and depression symptoms. Furthermore, players who sustained a concussion experienced subtle increases in anxiety and depressive symptoms in the short term and not in the long term. Players with who sustained an orthopaedic injury and healthy players did not show these changes in anxiety and depression symptom report. It appears that in this small sample concussion produced unique outcomes related to mental health functioning in the short term.
PRACTICEdefinition of the All Party Parliamentary Drugs Misuse Group (2000), which described dual diagnosis as 'the occurrence of a substance misuse problem and mental illness in the same patient at the same time', although the term 'mental illness' will be substituted by 'mental disorder' in order to include more severe personality disorder.The paper focuses on a male category B local prison with a population of approximately 600. Male prisons are categorised from A to D with A being the most secure and D the least -a 'D cat' is an open prison. All prisoners have a security risk assessment and are categorised according to risk. Nearly all prisoners are initially assigned a security category B on reception into prison, either remanded or convicted. Once convicted and risk-assessed most prisoners will This paper explores management and treatment processes for clients with a dual diagnosis in a local UK prison. Commentary on existing provision and service mapping based on the analysis will explore provision and systems in relation to the establishment of a dedicated dual diagnosis service. Generally accepted management and treatment principles will be synthesised to inform a service proposal specific to the needs of a male prison. The paper concludes with an implementation plan and the results of discussions with key stakeholders.The service proposal will not be restricted by definition of what dual diagnosis is but consider the morbidity as a spectrum with some aspects more disabling to a client's health and well-being than others.
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