A prospective study of children with head injures: III. Psychiatric sequelae

Brown, Gillian; Chadwick, Oliver; Shaffer, David; Rutter, Michael; Traub, Michael

doi:10.1017/s0033291700053289

Cited by 334 publications

(219 citation statements)

References 16 publications

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“…32 Novel psychiatric disorders diagnosed among patients with TBI in these studies were heterogeneous and included depressive disorders, anxiety disorders such as generalized anxiety disorder, panic disorder, posttraumatic stress disorder, and OCD, somatoform disorder, ADHD, and behavioral disorders such as oppositional-defiant disorder and conduct disorder. 4,[21][22][23][26][27][28]30,[34][35][36]49 Among the most common NPDs observed among prospective studies has been personality change resulting from a generalized medical condition, which has been diagnosed in up to 40% of pediatric patients after TBI but was not formally assessed in the present study. 22,36 Clinical variables associated with the development of NPDs after pediatric TBI include history of preinjury psychiatric disorder, family history of psychiatric illness, severity of injury, low socioeconomic status, and preinjury adaptive and intellectual functioning.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have observed novel psychiatric disorders (NPDs) occurring in 10%-100% of children and adolescents with TBI of various severities, including personality changes, attention-deficit hyperactivity disorder (ADHD), behavioral disorders, depression, and anxiety disorders. 4,21,22,[26][27][28]30,31,[33][34][35][36]49 Children and adolescents with psychiatric disorders are at risk for additional long-term comorbidities such as impaired school performance, 9 social isolation, 48 family dysfunction, 55 substance abuse, 45 and suicidal behavior. 19 Successful management of isolated pediatric mood disorders requires a multidisciplinary approach that includes behavioral and pharmacological treatment options.…”

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confidence: 99%

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Psychiatric outcomes after pediatric sports-related concussion

Ellis

Ritchie

Koltek

et al. 2015

PED

172

142

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J neurosurg Pediatr 16:709-718, 2015 abbreviations ADHD = attention-deficit hyperactivity disorder; ICD-10 = International Classification of Diseases, 10th Revision; IQR = interquartile range; NOS = not otherwise specified; NPD = novel psychiatric disorder; OCD = obsessive-compulsive disorder; PCS = postconcussion syndrome; PCSS = Post-Concussion Symptom Scale; SRC = sports-related concussion; TBI = traumatic brain injury. obJect The objectives of this study were twofold: 1) to examine the prevalence of emotional symptoms among children and adolescents with a sports-related concussion (SRC) who were referred to a multidisciplinary pediatric concussion program and 2) to examine the prevalence, clinical features, risk factors, and management of postinjury psychiatric outcomes among those in this clinical population. methods The authors conducted a retrospective chart review of all patients with SRC referred to a multidisciplinary pediatric concussion program between September 2013 and October 2014. Clinical assessments carried out by a single neurosurgeon included clinical history, physical examination, and Post-Concussion Symptom Scale (PCSS) scoring. Postinjury psychiatric outcomes were defined as a subjective worsening of symptoms of a preinjury psychiatric disorder or new and isolated suicidal ideation or diagnosis of a novel psychiatric disorder (NPD). An NPD was defined as a newly diagnosed psychiatric disorder that occurred in a patient with or without a lifetime preinjury psychiatric disorder after a concussion. Clinical resources, therapeutic interventions, and clinical and return-to-play outcomes are summarized. results One hundred seventy-four patients (mean age 14.2 years, 61.5% male) were included in the study. At least 1 emotional symptom was reported in 49.4% of the patients, and the median emotional PCSS subscore was 4 (interquartile range 1-8) among those who reported at least 1 emotional symptom. Overall, 20 (11.5%) of the patients met the study criteria for a postinjury psychiatric outcome, including 14 patients with an NPD, 2 patients with isolated suicidal ideation, and 4 patients with worsening symptoms of a preinjury psychiatric disorder. Female sex, a higher initial PCSS score, a higher emotional PCSS subscore, presence of a preinjury psychiatric history, and presence of a family history of psychiatric illness were significantly associated with postinjury psychiatric outcomes. Interventions for patients with postinjury psychiatric outcomes included pharmacological therapy alone in 2 patients (10%), cognitive behavioral therapy alone in 4 (20%), multimodal therapy in 9 (45%), and no treatment in 5 (25%). Overall, 5 (25%) of the patients with postinjury psychiatric disorders were medically cleared to return to full sports participation, whereas 5 (25%) were lost to follow-up and 9 (45%) remained in treatment by the multidisciplinary concussion program at the end of the study period. One patient who was asymptomatic at the time of initial consultation committed suicide. conclusions Emotiona...

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Psychiatric outcomes after pediatric sports-related concussion

Ellis

Ritchie

Koltek

et al. 2015

PED

172

142

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“…BEHAVIOURAL/EMOTIONAL OUTCOME Many authors have reported increased behavioural problems and psychiatric sequelae after childhood TBI, 17,18 including after mild injury.…”

Section: Methodsmentioning

confidence: 99%

The King's Outcome Scale for Childhood Head Injury and injury severity and outcome measures in children with traumatic brain injury

Calvert

Miller

Curran

et al. 2008

Develop Med Child Neuro

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The aim of this study was to relate discharge King's Outcome Scale for Childhood Head Injury (KOSCHI) category to injury severity and detailed outcome measures obtained in the first year post‐traumatic brain injury (TBI). We used a prospective cohort study. Eighty‐one children with TBI were studied: 29 had severe, 15 moderate, and 37 mild TBI. The male:female ratio was 1.8:1. The mean age was 11 years 10 months (SD 3.6, range 5–16y). Discharge KOSCHI categories were good (n=34), moderate (n=39), severe (n=6), and unclassifiable (n=2). KOSCHI category correlated strongly with admission Glasgow Coma Score, length of hospital stay, and post‐traumatic amnesia. It also correlated significantly with Verbal IQ and Performance IQ (Wechsler); measures of attention; health status (Health Utilities Index [HUI]); health‐related quality of life (Pediatric Quality of Life Inventory [PedsQL]); depressive symptoms (Birleson Depression Scale) assessed within 3 months postTBI; and with Verbal IQ, selective attention (map mission), and HUI and PedsQL domains assessed at least 6 months post‐TBI discharge. KOSCHI did not correlate with behaviour or executive function. We conclude that the KOSCHI scored at hospital discharge correlates with severity of injury and some cognitive, health status, and HRQL outcomes early after TBI. It is not helpful at predicting later difficulties, or behavioural and emotional problems.

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“…Traumatic brain injury (TBI) creates significant stress for both child and family (Brooks, 1991;Brown, Chadwick, Shaffer, Rutter, & Traub, 1981;Rivara et al, 1992;Wade, Taylor, Drotar, Stancin, & Yeates, 1998). The majority of children with moderate to severe brain injuries experience some cognitive and behavioral impairment Yeates et al, 2002).…”

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confidence: 99%

A Web-based family problem-solving intervention for families of children with traumatic brain injury

Wade

Wolfe

Pestian

2004

Behavior Research Methods, Instruments, & Computers

111

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We developed a Web-based intervention for pediatric traumatic brain injury (TBI) and examined its feasibility for participants with limited computer experience. Six families, including parents, siblings, and children with TBI, were given computers, Web cameras, and high-speed Internet access. Weekly videoconferences with the therapist were conducted after participants completed on-line interactive experiences on problem solving, communication, and TBI-specific behavior management. Families were assigned to videoconference with NetMeeting (iBOT cameras) or ViaVideo. Participants ranked the Web site and videoconferences as moderately to very easy to use. ViaVideo participants rated videoconferencing significantly more favorably relative to face-to-face meetings than did NetMeeting participants. Both the Web site and videoconferencing were rated as very helpful. All families demonstrated improved outcomes on one or more target behaviors, including increased understanding of the injury and improved parent-child relationships. All parents and siblings and all but 1 child with TBI said they would recommend the program to others. We conclude that a face-to-face intervention can be successfully adapted to the Web for families with varied computer experience.

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A prospective study of children with head injures: III. Psychiatric sequelae

Cited by 334 publications

References 16 publications

Psychiatric outcomes after pediatric sports-related concussion

Psychiatric outcomes after pediatric sports-related concussion

The King's Outcome Scale for Childhood Head Injury and injury severity and outcome measures in children with traumatic brain injury

A Web-based family problem-solving intervention for families of children with traumatic brain injury

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