A cross-sectional cohort study of post-concussive symptoms and their relationships with depressive symptoms in youth with and without concussion

Pulsipher, Dalin T.; Rettig, Eman K; Krapf, Erica M; Stanford, Lisa D.

doi:10.1080/02699052.2021.1942550

Cited by 4 publications

(4 citation statements)

References 38 publications

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“…In the current sample, headache, irritability, and drowsiness were the most common selfreported symptoms, which is in line with previous findings [31,32]. These symptoms may be due to the developmental stage of the participating adolescents (e.g., changes in sex hormones, brain structure and function, or psychological/social changes [27]), the presence of health conditions other than pTBI [33], and the cross-sectional study design, which is likely to have neglected variability in symptom burden [34]. Overall, researchers agree that PCS after pTBI tend to be injury non-specific, have a high overlap with other health conditions (e.g., depression), and should therefore be evaluated with caution [33].…”

Section: Discussionsupporting

confidence: 91%

“…Overall, researchers agree that PCS after pTBI tend to be injury non-specific, have a high overlap with other health conditions (e.g., depression), and should therefore be evaluated with caution [33]. In particular, an appropriate review of the medical history and anamnesis can facilitate diagnostic decisions [33]. A further comparison with the general population, as provided in the present study, would additionally allow differentiation of the extent of pTBI-related symptoms.…”

Section: Discussionmentioning

confidence: 72%

“…These symptoms may be due to the developmental stage of the participating adolescents (e.g., changes in sex hormones, brain structure and function, or psychological/social changes [27]), the presence of health conditions other than pTBI [33], and the cross-sectional study design, which is likely to have neglected variability in symptom burden [34]. Overall, researchers agree that PCS after pTBI tend to be injury non-specific, have a high overlap with other health conditions (e.g., depression), and should therefore be evaluated with caution [33]. In particular, an appropriate review of the medical history and anamnesis can facilitate diagnostic decisions [33].…”

Section: Discussionmentioning

confidence: 99%

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Reference Values for the Adolescent Post Version of the Postconcussion Symptom Inventory from the German General Population

Zeldovich,

Krol,

Timmermann

et al. 2024

Preprint

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Purpose The present study aims at providing reference values from the general pediatric population for the German version of the 21-item self-report post version of the Postconcussion Symptom Inventory for adolescents aged 13–17 years (PCSI-SR13) following pediatric traumatic brain injury (pTBI). Methods A total of N = 950 adolescents completed an adapted version of the PCSI-SR13. Prior to establishing reference values using percentiles, psychometric properties (i.e., reliability and factorial validity) and regression analyses were examined to identify factors contributing to PCSI-SR13 scores. In addition, construct assessment in the general population sample was compared to that in the pTBI sample (N = 234) using measurement invariance analyses and direct comparisons at the score levels. Results The results indicate good reliability (Cronbach’s α and McDonald’s ω of 0.97 each). The four-factor structure covering physical, emotional, cognitive, and fatigue symptom groups could be replicated with χ2(183) = 995.96, p < 0.001, χ2/df = 5.44, CFI = 0.99, TLI = 0.98, RMSEA[90% CI] = 0.068[0.064, 0.073], SRMR = 0.03. With minor restrictions, assessment of symptoms was comparable between the general population and the TBI samples. Participants in the pTBI sample reported a significantly higher symptom burden than those in the general population sample. Reference values were provided using the total sample without further stratification. Conclusions For the German post version of the PCSI-SR13, reference values are now available for direct score comparisons and for drawing conclusions about the clinical relevance of the reported symptoms, while considering the prevalence in a comparable general population without a history of pTBI. Trial registration The study is retrospectively registered in German Clinical Trials Register and in International Clinical Trials Registry Platform (ID DRKS00032854).

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

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Reference Values for the Adolescent Post Version of the Postconcussion Symptom Inventory from the German General Population

Zeldovich,

Krol,

Timmermann

et al. 2024

Preprint

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“…Despite the numerous requirements of concussion symptom lists, many items are generic and non specific. For example in one study, concussed youth endorsed a similar number of symptoms on a concussion symptom list to those with depression, anxiety, chronic pain or a medical diagnosis other than concussion [ 17 ]. In another study, baseline reporting of PCSI symptoms among youth athletes with no medical problems revealed endorsement of symptoms, including fatigue, drowsiness, headache, difficulty concentrating, nervousness and worry, in the absence of a concussion [ 18 ].…”

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confidence: 99%

Improving subacute management of post concussion symptoms: a pilot study of the Melbourne Paediatric Concussion Scale parent report

et al. 2022

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Aim: To pilot a modification of the Post Concussion Symptom Inventory, the Melbourne Paediatric Concussion Scale (MPCS) and examine its clinical utility. Materials & methods: A total of 40 families of concussed children, aged 8–18 years, were recruited from the emergency department. Parent responses to the MPCS in the emergency department and 2-weeks post injury determined child symptomatic status. Association between MPCS symptom endorsement and symptomatic group status was examined. Results: All additional MPCS items were endorsed by at least 25% of the parents of symptomatic children at 2 weeks. MPCS items were classified into nine symptom domains, with most falling in mood, neurological, autonomic and vestibular domains. Conclusion: The additional items and domain classifications in the MPCS have the potential to improve subacute diagnostic precision, monitoring of clinical recovery and identification of appropriate interventions post pediatric concussion.

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Reference values for the adolescent post version of the Postconcussion Symptom Inventory from the German general population

Zeldovich,

Krol,

Timmermann

et al. 2024

Eur J Pediatr

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The present study aims at providing reference values from the general pediatric population for the German version of the 21-item self-report post version of the Postconcussion Symptom Inventory for adolescents aged 13–17 years (PCSI-SR13) following pediatric traumatic brain injury (pTBI). A total of N = 950 adolescents completed an adapted version of the PCSI-SR13. Prior to establishing reference values using percentiles, psychometric properties (i.e., reliability and factorial validity) and regression analyses were examined to identify factors contributing to PCSI-SR13 scores. In addition, construct assessment in the general population sample was compared to that in the pTBI sample (N = 234) using measurement invariance analyses and direct comparisons at the score levels. The results indicate good reliability (Cronbach’s α and McDonald’s ω of 0.97 each). The four-factor structure covering physical, emotional, cognitive, and fatigue symptom groups could be replicated with χ2(183) = 995.96, p < 0.001, χ2/df = 5.44, CFI = 0.99, TLI = 0.98, RMSEA (90% CI) = 0.068 (0.064, 0.073), SRMR = 0.03. With minor restrictions, the assessment of symptoms was comparable between the general population and the pTBI samples. Participants in the pTBI sample reported a significantly higher symptom burden than those in the general population sample. Reference values were provided using the total sample without further stratification. Conclusion: For the German post version of the PCSI-SR13, reference values are now available for direct score comparisons and for drawing conclusions about the clinical relevance of the reported symptoms, while considering the prevalence in a comparable general population without a history of pTBI.Trial registration: The study is retrospectively registered in the German Clinical Trials Register and in the International Clinical Trials Registry Platform (ID DRKS00032854). What is Known: • Pediatric traumatic brain injury (pTBI) is a major cause of death and disability, with a wide range of incidence rates and symptoms that interfere with daily functioning and recovery.• The Postconcussion Symptom Inventory (PCSI), including recently translated and validated German versions, is a recommended tool for measuring self-reported symptoms in affected children and adolescents. What is New: • This study provides German-specific reference values for the PCSI-SR13, allowing health care professionals to better differentiate between symptoms that may occur in the general adolescent population with and without chronic health conditions and those caused by pTBI.• It highlights that adolescents with chronic health conditions but without a history of pTBI often report higher levels of emotional symptoms and fatigue, emphasizing the importance of a nuanced clinical assessment, including medical history.

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A cross-sectional cohort study of post-concussive symptoms and their relationships with depressive symptoms in youth with and without concussion

Cited by 4 publications

References 38 publications

Reference Values for the Adolescent Post Version of the Postconcussion Symptom Inventory from the German General Population

Reference Values for the Adolescent Post Version of the Postconcussion Symptom Inventory from the German General Population

Improving subacute management of post concussion symptoms: a pilot study of the Melbourne Paediatric Concussion Scale parent report

Reference values for the adolescent post version of the Postconcussion Symptom Inventory from the German general population

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