Anxiety After Severe Pediatric Closed Head Injury

Vasa, Roma A.; Gerring, Joan P.; Grados, Marco A.; Slomine, Beth S.; Christensen, James R.; Rising, William; Denckla, Martha B.; Riddle, Mark A.

doi:10.1097/00004583-200202000-00008

Cited by 56 publications

(78 citation statements)

References 19 publications

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“…Within the same cohort, children with TBI and obsessivecompulsive symptoms had significantly higher psychosocial adversity scores than children with TBI only, using unpaired student t tests (Grados et al, 2008). In contrast, psychosocial adversity was not correlated with either post-injury anxiety disorders or post-injury anxiety symptoms in this sample (Vasa et al, 2002). These varying contributions of childhood risk factors to the appearance of new psychiatric disorders in this sample emphasize the importance of including these predictor variables in studies examining behavioral and social outcomes of children and youth with TBI.…”

Section: Risk and Protective Factors In Tbi Researchmentioning

confidence: 80%

The Essential Role of Psychosocial Risk and Protective Factors in Pediatric Traumatic Brain Injury Research

Gerring

Wade

2012

Journal of Neurotrauma

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This article builds upon Traumatic Brain Injury Common Data Elements (TBI CDE) version 1.0 and the pediatric CDE Initiative by emphasizing the essential role of psychosocial risk and protective factors in pediatric TBI research. The goals are to provide a compelling rationale for including psychosocial risk and protective factors in addition to socioeconomic status (SES), age, and sex in the study design and analyses of pediatric TBI research and to describe recommendations for core common data elements in this domain. Risk and protective factor research is based on the ecological theory of child development in which children develop through a series of interactions with their immediate and more distant environments. Home, school, religious, and social influences are conceptualized as risk and/or protective factors. Child development and TBI researchers have interpreted risk and protective variables as main effects or as interactions and have used cumulative risk indices and moderation models to describe the relationship among these variables and outcomes that have to do with development and with recovery from TBI. It is likely that the number, type, and interaction among risk and protective factors each contribute unique variance to study outcomes. Longitudinal designs in TBI research will be essential to understanding the reciprocal relationships between risk/protective factors and the recovery/outcome made by the child. The search for effective interventions to hasten TBI recovery mandates the need to target modifiable risks and to promote protective factors in the child's environment.

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Section: Risk and Protective Factors In Tbi Researchmentioning

confidence: 80%

The Essential Role of Psychosocial Risk and Protective Factors in Pediatric Traumatic Brain Injury Research

Gerring

Wade

2012

Journal of Neurotrauma

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“…22,36 Clinical variables associated with the development of NPDs after pediatric TBI include history of preinjury psychiatric disorder, family history of psychiatric illness, severity of injury, low socioeconomic status, and preinjury adaptive and intellectual functioning. 20,22,25,31,34,54 In addition, psychosocial stress and family functioning have also been identified as important factors that affect the risk of developing NPDs after pediatric TBI. In the present study, patients with SRC who developed a postinjury psychiatric outcome were significantly more likely to be female, to have a preinjury psychiatric disorder, and to have a family history of psychiatric illness.…”

Section: Discussionmentioning

confidence: 99%

Psychiatric outcomes after pediatric sports-related concussion

Ellis

Ritchie

Koltek

et al. 2015

PED

166

142

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J neurosurg Pediatr 16:709-718, 2015 abbreviations ADHD = attention-deficit hyperactivity disorder; ICD-10 = International Classification of Diseases, 10th Revision; IQR = interquartile range; NOS = not otherwise specified; NPD = novel psychiatric disorder; OCD = obsessive-compulsive disorder; PCS = postconcussion syndrome; PCSS = Post-Concussion Symptom Scale; SRC = sports-related concussion; TBI = traumatic brain injury. obJect The objectives of this study were twofold: 1) to examine the prevalence of emotional symptoms among children and adolescents with a sports-related concussion (SRC) who were referred to a multidisciplinary pediatric concussion program and 2) to examine the prevalence, clinical features, risk factors, and management of postinjury psychiatric outcomes among those in this clinical population. methods The authors conducted a retrospective chart review of all patients with SRC referred to a multidisciplinary pediatric concussion program between September 2013 and October 2014. Clinical assessments carried out by a single neurosurgeon included clinical history, physical examination, and Post-Concussion Symptom Scale (PCSS) scoring. Postinjury psychiatric outcomes were defined as a subjective worsening of symptoms of a preinjury psychiatric disorder or new and isolated suicidal ideation or diagnosis of a novel psychiatric disorder (NPD). An NPD was defined as a newly diagnosed psychiatric disorder that occurred in a patient with or without a lifetime preinjury psychiatric disorder after a concussion. Clinical resources, therapeutic interventions, and clinical and return-to-play outcomes are summarized. results One hundred seventy-four patients (mean age 14.2 years, 61.5% male) were included in the study. At least 1 emotional symptom was reported in 49.4% of the patients, and the median emotional PCSS subscore was 4 (interquartile range 1-8) among those who reported at least 1 emotional symptom. Overall, 20 (11.5%) of the patients met the study criteria for a postinjury psychiatric outcome, including 14 patients with an NPD, 2 patients with isolated suicidal ideation, and 4 patients with worsening symptoms of a preinjury psychiatric disorder. Female sex, a higher initial PCSS score, a higher emotional PCSS subscore, presence of a preinjury psychiatric history, and presence of a family history of psychiatric illness were significantly associated with postinjury psychiatric outcomes. Interventions for patients with postinjury psychiatric outcomes included pharmacological therapy alone in 2 patients (10%), cognitive behavioral therapy alone in 4 (20%), multimodal therapy in 9 (45%), and no treatment in 5 (25%). Overall, 5 (25%) of the patients with postinjury psychiatric disorders were medically cleared to return to full sports participation, whereas 5 (25%) were lost to follow-up and 9 (45%) remained in treatment by the multidisciplinary concussion program at the end of the study period. One patient who was asymptomatic at the time of initial consultation committed suicide. conclusions Emotiona...

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“…20,21 Furthermore, rates of psychopathology do not appear to be influenced by age at injury 21,22 except for rare exceptions. 23 However, the association of age at injury and severity of psychiatric disorders has not been studied.…”

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confidence: 99%

Pediatric Stroke: Plasticity, Vulnerability, and Age of Lesion Onset

Max¹,

Bruce²,

Keatley³

et al. 2010

JNP

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The authors aim to investigate brain plasticity and vulnerability through the study of the relationship of age at the time of brain injury and neurocognitive and psychiatric outcome. Children with early stroke performed more poorly compared with children with late stroke in a wide variety of domains including intellectual function, language, memory, visuospatial function, academic function, and psychiatric problems. The exception to this pattern was that children with late stroke performed more poorly in two of three executive function tests. These findings suggest that in children with focal brain injury, as in those with more diffuse brain insults, younger age at injury predicts worse neurocognitive outcomes, although this may not apply to selected executive function outcomes. Adverse psychiatric outcome after early stroke is less direct but is evident in terms of severity in affected cases.

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Anxiety After Severe Pediatric Closed Head Injury

Cited by 56 publications

References 19 publications

The Essential Role of Psychosocial Risk and Protective Factors in Pediatric Traumatic Brain Injury Research

The Essential Role of Psychosocial Risk and Protective Factors in Pediatric Traumatic Brain Injury Research

Psychiatric outcomes after pediatric sports-related concussion

Pediatric Stroke: Plasticity, Vulnerability, and Age of Lesion Onset

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