wrote about a similar topic a bit ago, it which a relationship was
found between chronic
pain and depression in retired pro football players.
Now, there is an NTY article that reviews some findings about
a relationship between concussions and depression.
Tied to Depression in Ex-N.F.L. Players
By ALAN SCHWARZ
Published: May 31, 2007
The rate of diagnosed clinical depression among retired
National Football League players is strongly correlated with the number
of concussions they sustained, according to a study to be published
study was conducted by the University of North Carolina’s
Center for the Study of Retired Athletes and based on a general health
survey of 2,552 retired N.F.L. players. It corroborates other findings
regarding brain trauma and later-life depression in other subsets of
the general population, but runs counter to longtime assertions by the
N.F.L. that concussions in football have no long-term effects.
The study, which will appear in the journal of the American College of
Sports Medicine, found that of the 595 players who recalled sustaining
three or more concussions on the football field, 20.2 percent said they
had been found to have depression. That is three times the rate of
players who have not sustained concussions…
What is interesting about this article? In a way, nothing.
That is, the outcome of the study is pretty much what you
would expect. When you bash the brain around, bad things
What caught my attention about the article was the way it was written.
First, the author presents the findings. He notes
that the findings are consistent with other research, but that they
contradict what the NFL says:
corroborates other findings regarding brain trauma and later-life
depression in other subsets of the general population, but runs counter
to longtime assertions by the N.F.L. that concussions in football have
no long-term effects…
The NFL even cranked up their spin machine:
committee member, Dr. Henry Feuer of the Indiana University Medical
Center and a medical consultant for the Indianapolis Colts, went so far
as to call the center’s findings “virtually
Regarding the issue of players’ recollection of brain trauma,
Dr. Casson said: “They had no objective evaluations to
determine whether or not what the people told them in the surveys was
correct or not…
So far, this is standard operating procedure for a reporter.
You report what one side says, then give the other side a
chance to respond. That tends to be the format, regardless of
how lopsided the evidence is. Even if what one side has to
say is completely kooky, they get equal time. It leaves the
uninformed reader with the impression that there is a true dispute or
But Mr. Schwarz did not let this one go. He followed up:
reading the depression study and considering the league’s
issues with recollective survey research, Dr. John Whyte, the director
of the Moss Rehabilitation Research Institute in Philadelphia and an
expert in neurological research methodology, said he did not share the
“To the person who says this is worthless, let’s
just discard a third of the medical literature that we trust and go by
today,” said Dr. Whyte, who has no connection with either the
N.F.L. or the Center for the Study of Retired Athletes, which is partly
funded by the N.F.L. players union. “Here, the response rate
was good and not a relevant issue to the findings. We have some pretty
solid data that multiple concussions caused cumulative brain damage and
increased risk of depression, and that is not in conflict with the
“Do I think this one study proves the point beyond doubt? No.
Does it contribute in a meaningful way? You bet.”
Good. Then, Schwarz goes on to describe some of the high
points of the study methodology:
were on average 54 years old and had played almost seven seasons in the
N.F.L. A minimum of two seasons was required for inclusion in the study…
Of course, retrospective studies are not the best, but sometimes it is
all you have. Done well, they can provide valid information.
Considering that it would not be ethical to do a prospective,
randomized, controlled trial, you have to start somewhere.
The NFL plans to do its own study. No word on how they plan
to conduct it. Ideally, it would be a prospective study that
would either involve every single player, or would include a sizable,
random, representative sample.
Technicalities aside, I was glad to see the reporter make an effort to
present a complete view of the story, not merely a balanced view.