Background: Mental health conditions, such as depression, anxiety, and learning disabilities, are associated with symptoms that can overlap with those seen in persons with concussion. While concussion screening tools such as the Sport Concussion Assessment Tool–5th Edition (SCAT5) quantify the number of symptoms and symptom severity, it is not known whether these outcomes differ among individuals with concurrent mental health conditions compared with those without them. Purpose: To determine whether, during initial concussion assessment, individuals with a self-reported mental health condition have a significantly different number of self-reported concussion symptoms or symptom severity compared with those without a self-reported mental health condition (controls). Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective chart review was performed on consecutive patients aged ≥13 years who underwent post-concussion assessment at the Fowler Kennedy Sport Medicine Clinic between May 2018 and March 2020 (N = 765). Most participants did not self-report a mental health condition (n = 606; 79.2%). Participants with a self-reported mental health condition (n = 159) were classified as having a learning disability (n = 14; 8.8%), anxiety (n = 62; 39.0%), depression (n = 20; 12.6%), or multiple conditions (≥2 conditions: n = 63; 39.6%). Each participant with a mental health condition was matched with 2 control participants (overall pool, n = 318) based on age, sex, student status, and sport-related risk. Mann-Whitney U tests were used to determine the statistical significance of differences between each subgroup and their matched controls for the self-reported number of concussion symptoms and symptom severity as measured using the SCAT5. Results: The anxiety and multiple-conditions subgroups had a significantly greater number of reported symptoms than their corresponding control subgroups (median, 17 vs 15 [ P = .004] and 18 vs 14.5 [ P < .001], respectively). Additionally, the SCAT5 symptom severity score was significantly greater in the anxiety and multiple-conditions subgroups than their corresponding controls (median, 49 vs 34.5 [ P = .018] and 62 vs 32 [ P < .001], respectively). Conclusion: During initial concussion assessment, both the number of concussion-related symptoms and the symptom severity were greater in study participants with anxiety and multiple mental health conditions than participants without these conditions.

Abstract   Purpose: Balance is important to human functioning and is required to carry out daily tasks. Studies have shown that females have better balance than males. Mental health conditions are prevalent in undergraduate students, and we are unsure of their impact on balance. The purpose of this study was to investigate if sex or a mental health condition (attention deficit hyperactivity disorder (ADHD), generalized anxiety disorder, depression, or a combination of these conditions) are associated with changes in single-leg balance performance in undergraduate university students. Additionally, a secondary purpose was to investigate the relationship between weekly physical activity and balance performance.   Method: Sixty-nine (36 female, and 33 male) undergraduate students at Western University participated in this study. Participants completed three standardized assessment questionnaires to identify individuals with scores consistent with ADHD, anxiety, and depression. Individuals with more than one of these conditions formed the multiple condition group. The control group consisted of individuals that did not show scores that were consistent with a mental health condition. A Leisure Time Exercise Questionnaire was completed to quantify weekly physical activity, and a personal activity score was calculated for each participant. Finally, three 20-second single-leg standing balance trials were performed on a force plate, and balance performance was quantified using the path length. A two-way ANOVA assessed the relationship between sex and mental health conditions on standing balance. Results: There was no statistically significant interaction between sex and mental health conditions (P=0.15). However, path length in the multiple condition group was significantly higher than the control group (P < 0.05). In terms of activity scores and balance, there were no apparent trends between males and females nor between the different mental health groups. Conclusion: Our results indicate that sex was not associated with significant differences in balance performance, and that students with multiple mental health conditions had significantly worse single-leg balance performance than controls. Additionally, weekly physical activity was not associated with better balance performance. These results could be valuable for  clinicians when diagnosing balance related conditions, such as concussions.   Key Terms: Mental health, balance, single-leg, physical activity