Long term psychosocial outcomes after mild head injury in early childhood

McKinlay, Audrey; Dalrymple‐Alford, John C.; Horwood, L. John; Fergusson, David M.

doi:10.1136/jnnp.73.3.281

Cited by 210 publications

(167 citation statements)

References 53 publications

(32 reference statements)

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“…Fourteen patients developed NPDs, 2 patients developed isolated suicidal ideation, and 4 additional patients experienced worsening symptoms of a preinjury psychiatric disorder. Previous work has suggested a significant association between TBI and psychiatric disorders in children and adolescents, with rates significantly higher than those observed among uninjured 21,22,41,49 and orthopedically injured controls. 32 Novel psychiatric disorders diagnosed among patients with TBI in these studies were heterogeneous and included depressive disorders, anxiety disorders such as generalized anxiety disorder, panic disorder, posttraumatic stress disorder, and OCD, somatoform disorder, ADHD, and behavioral disorders such as oppositional-defiant disorder and conduct disorder.…”

Section: Discussionmentioning

confidence: 80%

Psychiatric outcomes after pediatric sports-related concussion

Ellis

Ritchie

Koltek

et al. 2015

PED

168

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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Section: Discussionmentioning

confidence: 80%

Psychiatric outcomes after pediatric sports-related concussion

Ellis

Ritchie

Koltek

et al. 2015

PED

168

142

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“…Clinical reports and available research suggest residual problems in cognition, attention, executive function, and memory. 3,4 These problems will interfere with skill acquisition, causing adaptive deficits, academic failure, and social and behavioral dysfunction, 5,6 as well as personal and economic burden for the family and community.…”

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confidence: 99%

Predictors of Cognitive Function and Recovery 10 Years After Traumatic Brain Injury in Young Children

et al. 2012

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BACKGROUND AND OBJECTIVES: Childhood traumatic brain injury (TBI) has implications for functional outcomes, but few studies have documented long-term outcomes. The purpose of this study was to plot recovery of cognitive and functional skills after early childhood TBI to 10 years postinjury and to identify the contribution of injury, environment, preinjury characteristics, and acute functional recovery. METHODS: Subjects were recruited consecutively to this prospective, longitudinal study, which used a between-factor design, with injury severity as the independent variable. Forty children with TBI aged 2 and 7 years were recruited on admission to a tertiary pediatric hospital, divided according to injury severity, and compared with 16 healthy controls acutely and 12 and 30 months and 10 years postinjury. Cognition, adaptive ability, executive function, and social/behavioral skills were examined. RESULTS: Children with severe TBI had poorest outcomes, with deficits greatest for cognition. Recovery trajectories were similar across severity groups but with significant gains in verbal skills from 12 and 30 months to 12 months and 10 years. Predictors of outcome included preinjury ability (for adaptive function) and family function (social/behavioral skills). CONCLUSIONS: Results confirm a high risk of persisting deficits after severe TBI in early childhood. Children with less severe TBI appear to recover to function normally. Contrary to speculation about “growing into deficits,” after protracted recovery to 30 months, young children make age-appropriate progress at least to 10 years postinsult. Environmental factors were found to contribute to adaptive and social/behavioral recovery.

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“…These groups of patients are active community groups, and this could be due to a higher prevalence of high-risk behavior in these age groups. These statistics are varying in different societies; results show that the most common brain injury is related to the third decade of life in developed countries (20)(21)(22)(23). Chiu et al revealed that the most common age group 20-29 years in Taiwan (24) and in a study that done in Norway, the most common head injury was reported in the 0-4 and above 75 years age groups.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological, Clinical and Radiological Characteristics of Patients with Head Trauma

Moghadam-Ahmadi

Vakilian

Farahmand

et al. 2017

IMMINV

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Background: Head injury has been recognized as a major public health problem and is a frequent cause of death and disability in young people and makes considerable demands on health services. Motor vehicle accidents are the major causes of traumatic brain injury (TBI) that its occurrence has been increasing in our country in recent years. We decided to study head injury in our region to evaluate the Epidemiological, clinical and radiological features of this health problem. Methods: We reviewed 200 TBI-patients records in Ali Ibn Abi Taleb hospital of Rafsanjan during 2012-2013. A Questionnaire including age, sex, job, the cause of trauma, Glasgow coma scale (GCS), brain computed tomography (CT) scan findings and clinical symptoms for every head trauma patient; was completed. Data were analyzed by SPSS software using Chi-square test and P-value less than 0.05 was considered significant. Results: From the total of 200 patients, 73.5% were males, and 26.5% were females. The most common age group was 20-24 years. The majority of patients were students. Traffic accidents were the major cause of injuries (64.5%), and 35.5% of them were a motorcyclist. The most frequent finding of brain CT scan was skull fracture, and subdural hematoma and 25% of patient had a severe head injury. In clinical symptoms in conscious patients, headache, nausea, vomiting and vertigo was common. Conclusion: This study showed that we should pay more attention to traumatic brain injury young patients who are the most active potential forces of our society. Traffic accidents are the major reason for head injuries. Pay attention to prevention of this accident can perform an important role in decreasing of head injuries.

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Long term psychosocial outcomes after mild head injury in early childhood

Cited by 210 publications

References 53 publications

Psychiatric outcomes after pediatric sports-related concussion

Psychiatric outcomes after pediatric sports-related concussion

Predictors of Cognitive Function and Recovery 10 Years After Traumatic Brain Injury in Young Children

Epidemiological, Clinical and Radiological Characteristics of Patients with Head Trauma

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