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Updated: Feb 7, 2026

A Multi-Modal Approach to Assessing Recovery in Youth Athletes Following Concussion
Published on: September 25, 2014
Depressive Symptoms in Concussed Youth Athletes: Factor Analysis of the Patient Health Questionnaire Modified for
Philip Schatz1, Melissa N Womble2, Kori Durfee3,4
1Department of Psychology, Saint Joseph's University, Philadelphia, USA.
Abstract:
The presentation of depression symptoms in concussed youth athletes is not well understood. We examined the PHQ-A factor structure in concussed youth athletes. Five hundred and ninety-five youth athletes completed the PHQ-A and PCSS within 30 days of sport-related concussion. Factor analyses of the PHQ-A alone revealed a two-factor structure: cognitive-energy/sleep and emotional symptoms. When combined, only two PCSS items ("sadness," "more emotional") overlapped with PHQ-A symptoms. Over half (51.1%) of youth athletes endorsed symptoms consistent with mild-to-severe depression; athletes with preexisting anxiety or depression had a 1.6-3.2x greater likelihood of meeting depression criteria. The PHQ-A provides unique clinical information beyond standard post-concussion assessments.
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