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Objective Identifying risk factors is important in adolescent sports concussions. This study aimed to explore the relationship between affective symptoms and physical symptoms in youth concussions. Design Athletes were split into two groups: self-reported emotional symptoms (irritability/aggression, anxiety, depression, apathy, and/or labile mood; EMO, n=22) and a control group without emotional symptoms (CON, n=15). Groups were examined for differences between post-concussive symptoms and peri-concussive factors. Setting Outpatient clinic. Participants 37 concussed adolescents age 12–17 with persisting concussion symptoms were assessed. Concussion diagnoses were indicated by traumatically induced alterations in mental status (with or without LOC), disruption in brain functioning (memory loss/neurological deficits), and other physiologic symptoms post-concussion. Those with baseline psychiatric history and/or special education were excluded. Assessment of risk factors Post-concussive symptom variable relationships were assessed. Outcome measures group differences were analysed using ANOVAs. Results No differences between positive LOC, positive amnesia, or post-concussive criteria existed, indicating likely comparable severity. While there were no group differences for number of concussions, headaches, or nausea, those in EMO were significantly more likely to endorse photo-sensitivity (p=0.003, F=10.155) and phono-sensitivity (p=0.007, F=8.108). Both anxiety and irritability/aggression were significantly (p Conclusions Results indicate that adolescents who self-report emotional difficulties following sports concussion are more likely to endorse some physical symptoms, particularly photo-sensitivity and phono-sensitivity. Those experiencing anxiety or irritability are also more likely to experience increased attentional difficulties. Competing interests None.

Objective To assess whether irritability and aggression are viable indicators of persistent post-concussive symptoms in adolescents. Design Group differences between those diagnosed with concussions were analysed using ANOVAs (p Setting Outpatient clinic. Participants 46 concussed adolescents age 12–17 with persisting concussion symptoms were assessed. Athletes were split into two groups: those endorsing irritability/aggression (AGG, n=24) and a control group of those denying irritability/aggression (CON, n=22). Those with baseline psychiatric history and/or special education were excluded. Assessment of risk factors Post-concussive symptom variable relationships were assessed. Outcome measures group differences were analysed using ANOVAs. Results Adolescents endorsing irritability/aggression reported more fatigue (p=0.002), disordered sleep (p=0.001), anxiety (p=0.028), depression (p=0.003), and mood lability (p Conclusions Results indicate that adolescents with self-reported irritability and aggression post-concussion were more likely to display more affective symptoms than those who did not endorse irritability and aggression following concussions. They were also more likely to complain of fatigue and disordered sleep. These findings suggest that change in level of irritability/aggression could potentially serve as an identifiable indicator for parents and coaches to recognise when an adolescent is not recovering well post-concussion. Competing interests None.