Elevated Anxiety and Depression Symptoms in Injured and Uninjured Adolescents

INTRODUCTION: Musculoskeletal injuries are common among adolescents with roughly half reporting an injury in the last year. Injury impairs function, but it may impact psychological or behavioral well-being as well. Mental health concerns such as anxiety and depression can negatively affect an adolescent’s quality of life. As mental health disorders are being seen more frequently in the young population it is important to understand their relationship with injury. Athletes who are no longer able to participate in their normal activities due to injury may have elevated symptoms of anxiety and depression from this sudden lifestyle change. The purpose of this study was to determine if a musculoskeletal injury is associated with elevated anxiety and depression in adolescent athletes. METHODS: Adolescents between the ages of 12-18 from sports medicine clinics presenting with musculoskeletal injuries were age and sex matched to non-injured adolescents from high school health and weight training classes as well as adolescent medicine clinics. The General Anxiety Disorder-7 and Patient Health Questionnaire-9 were used to assess for anxiety and depression symptoms, respectively. Scores of ≥5 on each questionnaire were considered elevated. Chi-Square analyses analyzed the differences in proportions of elevated anxiety and depression in the injured and uninjured participants. RESULTS: Matched data was available for 108 participants, 54 in each group. Average age was 15.99± 1.58 and 83% were females. Overall, 41% reported elevated anxiety symptoms and 36% reported elevated depressive symptoms. There were no differences in the proportion of injured adolescents that had elevated anxiety or depression compared to uninjured adolescents (p=.386 and p=.071, respectively). DISCUSSION: Elevated anxiety and depressive symptoms are common among injured and non-injured adolescents. High rates in our sample could be impacted by the predominance of female participants, as female are more likely to experience this symptomology than males. It is possible that the severity of the injury may influence anxiety and depression symptoms, which we did not assess. In addition, participants were enrolled during COVID-19, which may have influenced the rates of elevated anxiety and depression symptoms. Elevated anxiety and depressive symptoms are associated with high levels of functional impairment. Therefore, adolescents should be routinely assessed for anxiety and depression, regardless of injured status.