When a minor head injury results in enduring symptoms: a prospective investigation of risk factors for postconcussional syndrome after mild traumatic brain injury
When a minor head injury results in enduring symptoms: a prospective investigation of risk factors for postconcussional syndrome after mild traumatic brain injury
Objective A significant proportion (15–30%) of patients with mild traumatic brain injury (MTBI) are at risk of developing postconcussional syndrome (PCS). The aim of this study was to investigate the contributions of cognitive, emotional, behavioural and social factors to the development of PCS and identify early predictors.
Methods A prospective cohort design was employed. 126 MTBI patients completed baseline questionnaire assessments within 2 weeks of the injury and 107 completed follow-up questionnaire assessments at 3 and 6 months. A series of self-report measures were used to assess cognitive, behavioural and emotional responses to MTBI. The primary outcome was the ICD-10 diagnosis for PCS. Demographic and clinical characteristic variables were compared between PCS cases and non-cases using independent sample t tests and ?2 tests. Individual and multivariate logistic regression analyses were used to detect predictors of PCS.
Results Of 107 MTBI patients, 24 (22%) met the criteria for PCS at 3 months and 22 (21%) at 6 months. Individual logistic regression analysis indicated that negative MTBI perceptions, stress, anxiety, depression and all-or-nothing behaviour were associated with the risk of PCS. Multivariate analysis revealed that all-or-nothing behaviour was the key predictor for the onset of PCS at 3 months while negative MTBI perceptions predicted PCS at 6 months.
Conclusions The study provides good support for the proposed cognitive behavioural model. Patients' perceptions of their head injury and their behavioural responses play important roles in the development of PCS, indicating that cognitive and behavioural factors may be potential targets for early preventive interventions.
217-223
Hou, Ruihua
470bdcbc-93a9-4dad-aac5-26d455c34376
Moss-Morris, Rona
a502f58a-d319-49a6-8aea-9dde4efc871e
Peveler, Robert
93198224-78d9-4c1f-9c07-fdecfa69cf96
Mogg, Karin
5f1474af-85f5-4fd3-8eb6-0371be848e30
Bradley, Brendan P.
bdacaa6c-528b-4086-9448-27ebfe463514
Belli, Antonio
33707b7b-b004-4245-aead-98a8e1e2b2e2
25 February 2012
Hou, Ruihua
470bdcbc-93a9-4dad-aac5-26d455c34376
Moss-Morris, Rona
a502f58a-d319-49a6-8aea-9dde4efc871e
Peveler, Robert
93198224-78d9-4c1f-9c07-fdecfa69cf96
Mogg, Karin
5f1474af-85f5-4fd3-8eb6-0371be848e30
Bradley, Brendan P.
bdacaa6c-528b-4086-9448-27ebfe463514
Belli, Antonio
33707b7b-b004-4245-aead-98a8e1e2b2e2
Hou, Ruihua, Moss-Morris, Rona, Peveler, Robert, Mogg, Karin, Bradley, Brendan P. and Belli, Antonio
(2012)
When a minor head injury results in enduring symptoms: a prospective investigation of risk factors for postconcussional syndrome after mild traumatic brain injury.
Journal of Neurology, Neurosurgery and Psychiatry, 83 ((2)), .
(doi:10.1136/jnnp-2011-300767).
(PMID:22028384)
Abstract
Objective A significant proportion (15–30%) of patients with mild traumatic brain injury (MTBI) are at risk of developing postconcussional syndrome (PCS). The aim of this study was to investigate the contributions of cognitive, emotional, behavioural and social factors to the development of PCS and identify early predictors.
Methods A prospective cohort design was employed. 126 MTBI patients completed baseline questionnaire assessments within 2 weeks of the injury and 107 completed follow-up questionnaire assessments at 3 and 6 months. A series of self-report measures were used to assess cognitive, behavioural and emotional responses to MTBI. The primary outcome was the ICD-10 diagnosis for PCS. Demographic and clinical characteristic variables were compared between PCS cases and non-cases using independent sample t tests and ?2 tests. Individual and multivariate logistic regression analyses were used to detect predictors of PCS.
Results Of 107 MTBI patients, 24 (22%) met the criteria for PCS at 3 months and 22 (21%) at 6 months. Individual logistic regression analysis indicated that negative MTBI perceptions, stress, anxiety, depression and all-or-nothing behaviour were associated with the risk of PCS. Multivariate analysis revealed that all-or-nothing behaviour was the key predictor for the onset of PCS at 3 months while negative MTBI perceptions predicted PCS at 6 months.
Conclusions The study provides good support for the proposed cognitive behavioural model. Patients' perceptions of their head injury and their behavioural responses play important roles in the development of PCS, indicating that cognitive and behavioural factors may be potential targets for early preventive interventions.
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Published date: 25 February 2012
Organisations:
Psychology, Clinical & Experimental Sciences
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Local EPrints ID: 201595
URI: http://eprints.soton.ac.uk/id/eprint/201595
ISSN: 1468-330X
PURE UUID: f47ab8bc-a189-4010-a9dc-7297c8e12e8f
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Date deposited: 31 Oct 2011 14:56
Last modified: 15 Mar 2024 03:28
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Author:
Rona Moss-Morris
Author:
Antonio Belli
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