The Impact of Affective States on Postconcussive Symptoms in a TBI Population

Abstract

The occurrence of persistent postconcussive symptoms (PCS) associated with traumatic brain injury (TBI) is an increasing cause of disability and lost productivity. The reasons for these persistent symptoms in a percentage of even mild TBI are poorly understood. The existence of comorbid conditions such as post-traumatic stress disorder or other traumatic injuries may be factors that impact the presence of PCS. We expect that greater levels of affective symptoms will be associated with increases in PCS assessed on the Neurobehavioral Symptom Inventory (NSI). TBI subjects (N = 69) who were seen 1 year post-injury were recruited from a larger cohort study of TBI. Subjects were administered the NSI, Brief Symptom Inventory-18 (BSI-18) and the Post Traumatic Stress Disorder Checklist (PCL). Data were analyzed using Spearman’s rho correlations and analysis of variances. We found significant correlations between the four NSI factors and the three BSI factors and the PCL total score. Mild TBI subjects were found to have the highest correlations between affective and somatic symptoms. These findings support our hypothesis that affective states are associated with higher PCS reporting and that early identification and treatment may decrease PCS.

Military TBI—What civilian primary care providers should know

“…PTSD can also influence treatment and time to recovery, as well as symptom severity after mTBI, often leading to more disabling postconcussive symptoms. [ 33 34 35 36 ] Therefore, special attention must be paid to the possibility of comorbid PTSD and mTBI in SMs and veterans. Many SMs diagnosed with PTSD report feeling a stigma about this “psychological” condition, and because of this are less likely to seek treatment, resulting in poorer mental health outcomes.…”

Risk of Migraine after Traumatic Brain Injury and Effects of Injury Management Levels and Treatment Modalities: A Nationwide Population-Based Cohort Study in Taiwan

“…TBI causes not only short-term impairment, but also persistent and even life-long consequences [ 7 ]. Negative outcomes following TBI include persistent postconcussive symptoms (PCS) [ 8 ], neurodegenerative disorders [ 9 ], psychological disorders, including post-traumatic stress disorder (PTSD) [ 10 ], psychiatric sequelae [ 11 ], sleep disturbances [ 12 ], autonomic dysfunction [ 13 ], and suboptimal health-related quality of life, particularly in women [ 14 ]. Of these, headache is one of the most common postconcussive disorders [ 15 ].…”