Hi, my name is Shane Sharestani. I'm an MD-PhD student in the combined USC-Caltech program, and this talk will focus on clinical depression and suicidal ideation rates following concussion. Disclosures. We have no relevant disclosures or conflicts of interest, and no sources of funding were used to conduct this study. As an introduction, conclusion and mild traumatic brain injury have been identified as potential risk factors for the development of neurodegenerative disorders, two of the most common being Alzheimer's and Parkinson's disease. Although much of the current literature looks at long-term neurodegenerative consequences, it's important to understand the short-term psychological effects of following concussion and mild traumatic brain injury. And in this current study, we evaluate the prevalence of depression and suicidal ideation following concussion using a nationally representative cohort of patients in the United States. To conduct the study, we used a 2016 national inpatient sample in which we found 7,253 patients diagnosed with concussion in 2016. We then used relevant ICD-10 codings to stratify these patients into those who were admitted for initial and subsequent encounters, with initial having 6,800 and subsequent having about 450, and we analyzed the prevalence of clinically diagnosed depression and suicidal ideation at each of these time points. Statistical analysis was conducted in our studio with the Welsh two-sample t-tests used to obtain key values. Our results, we found significantly higher rates of clinically diagnosed depression in patients who came at subsequent encounters for a concussion compared to those who came at an initial encounter. And you can see the rates there, 20.7% at subsequent versus 8.7% at initial, and that was significant. We also found that in subsequent patient encounters, more than half were female, and this value was significant, and that suicidal ideation was also higher in patients at subsequent encounters compared to the initial encounter for a concussion, and that was 2.71% versus 0.54%, and that was also significant. Lastly, we found that there were significant differences in age of individuals with suicidal ideation, with those having suicidal ideation being significantly younger than those not having suicidal ideation at subsequent encounters. Here's a couple bar charts depicting our findings. The light blue is initial encounter, and the purple is subsequent encounter, and you can see that depression rates almost double at the subsequent encounter, and suicidal ideation increases by almost a factor of five between initial and subsequent encounters. This data suggests that following concussion, the rates of clinically diagnosed depression and suicidal ideation may increase. Women may be at a greater risk of developing depression, and younger individuals may be at a greater risk of developing suicidal ideation. We're currently conducting future studies using the National Readmission Database, which is similar to the NIS that we used in this study. However, this new database provides readmission data, so we can actually analyze which patients are readmitted and track them over a year, a calendar year, to look at who is developing psychiatric conditions, and in this study, we plan to use multivariate analysis controlling for age, sex, and comorbidities as covariates. As a summary, we found that the risk of acute psychiatric illness may increase following concussion or mild traumatic brain injury, and further studies are warranted to better understand the patient cohorts that are at highest risk of novel psychiatric conditions following concussion to better help with patient follow-up and patient triage. Thank you for your time.

Shane Sharestani

MD-PhD student

clinical depression

suicidal ideation

concussion