Sex Differences and Reporting of SCAT-5 Concussion Symptoms in Adolescent Athletes

Objective:To elucidate specific symptoms that may differ between adolescent female and male athletes after a sports-related concussion (SRC) and identify symptoms that may require greater clinical attention by medical and athletic staff.Design:Prospective.Setting:This study is part of a larger research project conducted at clinics in the North Texas Concussion Network (ConTex) Registry.Participants:Subjects (N = 491) aged 12 to 18 years who sustained a diagnosed SRC within 30 days of clinic visit.Independent Variables:Sex (female vs male). Covariates included age, race, current mood (anxiety and depression), learning disability/ADHD, and time to clinic.Main Outcome Measures:Twenty-two individual postconcussion symptoms as measured by the Post-Concussion Symptom Scale from the Sport Concussion Assessment Tool-5 (SCAT-5).Results:Girls endorsed higher levels of anxiety and depression symptoms at initial clinic visit. analysis of covariance results revealed that girls had significantly greater symptom severity of headache, dizziness, sensitivity to light, sensitivity to noise, pressure in the head, feeling slowed down, fatigue, and drowsiness than boys. Ordinal logistic regression results also revealed that girls had significantly greater predicted odds of higher symptom severity on these 8 symptoms and in trouble concentrating than boys.Conclusions:Closer examination of specific symptoms with attention to patients' current levels of anxiety and depression symptoms may better inform medical and athletic staff to anticipate and address symptoms that may present greater challenges for adolescent girls than boys.