Article

Predictors of Postconcussive Symptoms 3 Months After Mild Traumatic Brain Injury

Monash University, Melbourne, Australia.
Neuropsychology (Impact Factor: 3.43). 04/2012; 26(3):304-13. DOI: 10.1037/a0027888
Source: PubMed

ABSTRACT There is continuing controversy regarding predictors of poor outcome following mild traumatic brain injury (mTBI). This study aimed to prospectively examine the influence of preinjury factors, injury-related factors, and postinjury factors on outcome following mTBI.
Participants were 123 patients with mTBI and 100 trauma patient controls recruited and assessed in the emergency department and followed up 1 week and 3 months postinjury. Outcome was measured in terms of reported postconcussional symptoms. Measures included the ImPACT Post-Concussional Symptom Scale and cognitive concussion battery, including Attention, Verbal and Visual memory, Processing Speed and Reaction Time modules, pre- and postinjury SF-36 and MINI Psychiatric status ratings, VAS Pain Inventory, Hospital Anxiety and Depression Scale, PTSD Checklist-Specific, and Revised Social Readjustment Scale.
Presence of mTBI predicted postconcussional symptoms 1 week postinjury, along with being female and premorbid psychiatric history, with elevated HADS anxiety a concurrent indicator. However, at 3 months, preinjury physical or psychiatric problems but not mTBI most strongly predicted continuing symptoms, with concurrent indicators including HADS anxiety, PTSD symptoms, other life stressors and pain. HADS anxiety and age predicted 3-month PCS in the mTBI group, whereas PTSD symptoms and other life stressors were most significant for the controls. Cognitive measures were not predictive of PCS at 1 week or 3 months.
Given the evident influence of both premorbid and concurrent psychiatric problems, especially anxiety, on postinjury symptoms, managing the anxiety response in vulnerable individuals with mTBI may be important to minimize ongoing sequelae.

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    • "ypical symptoms that may occur in the first weeks following an injury to help adapting the child ' s schedule and activities . Comprehensive informa - tion is not only important to prevent excessive physical and cognitive strains after the injury ( Sady et al . , 2011 ) , but also to minimize parental stress and optimize coping with the incident ( Ponsford et al . , 2001 ) . Although there were no post - acute neuropsychological or socio - behavioral differences between children after mTBI and OI , our findings indicate that current and pre - injury everyday attention problems were negatively associated with neuropsychological performance in children after mTBI . Thus , future research should focus on f"
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