Predictors for Psychological Distress 2 Months After Mild Traumatic Brain Injury.

Eirik Vikane,Hanne Langseth Næss,Kaia Frøyland,Jörg Aßmus,Jan Sture Skouen

doi:10.3389/fneur.2019.00639

Eirik Vikane, Hanne Langseth Næss + Show 3 more

Open Access

https://doi.org/10.3389/fneur.2019.00639

Copy DOI

Abstract

Objective: To predict psychological distress at 2 months for patients with mild traumatic brain injury.Method: A prospective cohort study of 162 patients with mild traumatic brain injury (MTBI) admitted consecutively to an outpatient clinic at Haukeland University Hospital, Norway. Demographic data were obtained from Statistics Norway and injury characteristics were obtained from the hospital records. Sick leave data from the last year before the injury were obtained from The Norwegian Labor and Welfare Service. Self-report questionnaires were used to obtain history about earlier disease and symptom profiles. The Hospital Anxiety and Depression Scale (HAD) detecting states of depression and anxiety were used as the dependent variable in a stepwise linear regression. Pre-injury factors and injury-related factors were examined as potential predictors for HAD.Results: In the first steps we observed a significant association between HAD at 2 months and education, whiplash associated disorder (WAD), and earlier sick listed with a psychiatric diagnosis. In the final step there was an association only between HAD and self-reported anxiety and WAD. There were no associations between HAD and injury-characteristics like severity at Glasgow Coma Scale or intracranial injury.Conclusion: Patients with low education, earlier psychiatric diagnosis, self-reported earlier anxiety and WAD were more likely to develop a psychological distress after a MTBI. These findings should be taken into consideration when treating patients with MTBI.

Highlights

Mild traumatic brain injury (MTBI) is a major public-health concern, and more than 600 patients per 100,000 people are suffering a MTBI [1, 2]
post-concussion symptoms (PCS) are more common among MTBI-patients compared to other patients suffering a non-head trauma [4, 12]
As presented in an earlier published paper, we identified 343 patients with MTBI admitted consecutively to the Departments of Neurosurgery from January 2009 to July 2011 [39]

Summary

Introduction

Mild traumatic brain injury (MTBI) is a major public-health concern, and more than 600 patients per 100,000 people are suffering a MTBI [1, 2]. Common acute symptoms are headache, fatigue, dizziness and cognitive impairment associated with pain, sleep disturbance and psychological distress [4, 5]. For the majority of patients with a MTBI the symptoms resolve, but between 5 and 20% develops post-concussion symptoms (PCS) lasting more than 12 months [4, 6,7,8,9,10,11]. PCS are more common among MTBI-patients compared to other patients suffering a non-head trauma [4, 12]. PCS can be divided into somatic, cognitive, and emotional complaints [13]. Dizziness, nausea, fatigue, problems with vision, noise sensitivity, and sleeping problems. Cognitive symptoms include problems with memory or concentration and reduced speed of processing. Anxiety, frustration, and irritability [6, 14]

Methods

Results

Conclusion