The Primary Role of Mental Health Treatment in Resolution of Persistent Post-concussive Symptoms

Abstract

Symptoms that persist beyond the expected period of recovery following a mild traumatic brain injury (mTBI)/concussion are strongly linked to non-neurologic variables, notably mental health conditions such as posttraumatic stress disorder (PTSD), particularly among Iraq and Afghanistan Veterans. Despite acknowledgement of poor recovery in a sizeable minority of concussion cases and the strong contribution of psychological factors to this presentation, treatment of comorbid, and likely primary, mental health conditions, is not as widely practiced as the evidence would support. The attention drawn to TBI as a “signature injury” of the conflicts in Iraq and Afghanistan as well as from contact sports has had a positive impact on TBI awareness, identification, and prevention efforts. However, it may have had the unintended consequence of overshadowing treatment of comorbid mental health conditions and other symptomatic treatments that are likely to impart the greatest symptom reduction and treatment gains. Individuals with a history of concussion can successfully engage in structured mental health treatments and using cognitive behavioral treatments for psychiatric conditions, such as PTSD and depression, as primary treatment approaches for reducing persistent post-concussive symptoms is supported by the current research literature.