The Relationship Between Prior Concussions and Depression Is Modified by Somatic Symptomatology in Retired NFL Athletes

J Neuropsychiatry Clin Neurosci. 2019 Winter;31(1):17-24. doi: 10.1176/appi.neuropsych.18040080. Epub 2018 Sep 6.


A positive relationship between sport-related concussion (SRC) history and depressive symptoms in retired National Football League (NFL) athletes has been observed, with self-rated physical functioning identified as a confounding factor. The authors examined the influence of somatic symptom endorsement on the relationship between SRC history and self-reported depressive symptom severity in retired NFL athletes. Forty-three former NFL athletes completed self-report inventories of depression (with the Beck Depression Inventory II) and somatic symptoms (with the adjusted Patient Health Questionnaire-15). A moderation analysis examined the influence of somatic symptoms on the relationship between SRC history and depressive symptom severity. SRC history and somatic symptoms accounted for a significant amount of depressive symptomology. SRC history was not significantly associated with depressive symptom severity at low levels of somatic symptoms but was significant at the mean and high levels. The effect of somatic symptoms on depressive symptoms was nearly twice that of SRC history. The relationship between SRC and depression is complex, and treatment of depression in retired athletes should address comorbid somatic symptoms.

Keywords: Concussion; Depression; National Football League; Somatic Symptoms; Traumatic Brain Injury.

MeSH terms

  • Adult
  • Athletes / statistics & numerical data
  • Athletic Injuries / epidemiology*
  • Brain Concussion / epidemiology*
  • Comorbidity
  • Depression / epidemiology*
  • Depressive Disorder / epidemiology*
  • Football / injuries*
  • Humans
  • Male
  • Medically Unexplained Symptoms*
  • Middle Aged
  • Pain / epidemiology*
  • Retirement
  • Severity of Illness Index