Predictors of Long-Term Psychosocial Functioning and Health-Related Quality of Life in Children and Adolescents With Prior Concussions

Plourde, Vickie; Yeates, Keith Owen; Brooks, Brian L.

doi:10.1017/s1355617718000061

Cited by 28 publications

(15 citation statements)

References 55 publications

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“…Our findings and those of other researchers suggest that individuals with concussion are prone to internalized psychological concerns, at least while they are symptomatic. A recent study by Plourde, Yeates, and Brooks (2018) did not find group differences on psychosocial measures at approximately 36 months after injury (vs. 2 months postinjury in this study), so it appears that academic and emotional concerns after concussion do subside over time.…”

Section: Discussioncontrasting

confidence: 53%

Effects of Concussion in Adolescent Students: Perceptions and Performance

Rieger

Lewandowski

Potts

et al. 2019

J Int Neuropsychol Soc

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Objective: The purpose of this study was to compare adolescent students with and without concussion on a battery of academic, neurocognitive, and socioemotional measures and assess the aftereffects of concussion across domains of functioning. Methods: Twenty-four adolescents (ages 13–17) reporting postconcussion symptoms were compared to 24 controls matched for age and gender across a battery of tests and surveys. Results: After correcting for multiple comparisons, there were no significant differences on any neuropsychological measures. Similarly, there were no significant group differences on academic measures of vocabulary, word recognition, or reading comprehension. Self-reported concussion symptoms were much greater for students with concussion, as were self-reports of anxiety, depression, and somatization symptoms. Parents also rated those with concussion as having greater depression and somatization symptoms, but not to a degree that survived Bonferroni correction. Lastly, those with concussion reported a significantly greater number of school problems and academic concerns. Conclusions: Results indicated that adolescents who reported postconcussion symptoms do not perform differently from peers on most neurocognitive and academic tasks, yet they showed considerably more worry, somatization, academic concerns, and feelings of inadequacy than matched controls. The findings suggest that interventions to address psychological and academic stress may be indicated for adolescents symptomatic from concussion.

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Section: Discussioncontrasting

confidence: 53%

Effects of Concussion in Adolescent Students: Perceptions and Performance

Rieger

Lewandowski

Potts

et al. 2019

J Int Neuropsychol Soc

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“…This is consistent with our previous longitudinal study of HRQOL among adolescent SRC patients 34 and a more recent study that demonstrated no persistent impairments in HRQOL or psychological functioning among adolescents with a history of one or multiple concussions compared to those with an orthopedic injury. 31 Our results have potentially important implications for the clinical management of acute pediatric SRC patients. Although most pediatric SRC patients will attain neurological recovery within 1-4 weeks, an important proportion will experience persistent symptoms that contribute to delayed clinical recovery.…”

Section: Discussionmentioning

confidence: 76%

Health-related quality of life following adolescent sports-related concussion or fracture: a prospective cohort study

Russell

Selci

Black³

et al. 2019

Journal of Neurosurgery: Pediatrics

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OBJECTIVEThe longitudinal effects of sports-related concussion (SRC) in adolescents on health-related quality of life (HRQOL) remain poorly understood. Hence, the authors established two objectives of this study: 1) compare HRQOL outcomes among adolescents with an acute SRC or a sports-related extremity fracture (SREF) who were followed up until physician-documented clinical recovery; and 2) identify the clinical variables associated with worse HRQOL among adolescent SRC patients.METHODSThe authors conducted a prospective cohort study of adolescents with acute SRC and those with acute SREF who underwent clinical assessment and follow-up at tertiary subspecialty clinics. Longitudinal patient-reported HRQOL was measured at the time of initial assessment and at each follow-up appointment by using the adolescent version (age 13–18 years) of the Pediatric Quality of Life Inventory (PedsQL) Generic Core Scale and Cognitive Functioning Scale.RESULTSA total of 135 patients with SRC (60.0% male; mean age 14.7 years; time from injury to initial assessment 6 days) and 96 patients with SREF (59.4% male; mean age 14.1 years; time from injury to initial assessment 8 days) participated in the study. At the initial assessment, the SRC patients demonstrated significantly worse cognitive HRQOL and clinically meaningful impairments in school and overall HRQOL compared to the SREF patients. Clinical variables associated with a worse HRQOL among SRC patients differed by domain but were significantly affected by the patients’ initial symptom burden and the development of delayed physician-documented clinical recovery (> 28 days postinjury). No persistent impairments in HRQOL were observed among SRC patients who were followed up until physician-documented clinical recovery.CONCLUSIONSAdolescent SRC is associated with temporary impairments in HRQOL that have been shown to resolve in patients who are followed up until physician-documented clinical recovery. Future studies are needed to identify the clinicopathological features that are associated with impaired HRQOL and to assess whether the initiation of multidisciplinary, targeted rehabilitation strategies would lead to an improvement in HRQOL.

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“…Previous studies have found that demographics (sex and age), medical history, history of psychiatric disorders, and neurodevelopmental conditions are associated with prolonged symptoms postconcussion. 6,7,11,14,17,[55][56][57][58] In addition, individuals with lower preinjury resiliency scores had increased concussion and anxiety symptoms 1 week and 1 month postinjury. 59 Our results demonstrate that preinjury symptoms captured with the PCSI (physical and emotional), personal characteristics such as age and sex and time from injury to ED, and parental postinjury physical symptom ratings explained most of the variance in PPCS at 4 weeks.…”

Section: Discussionmentioning

confidence: 99%

“…Severity of acute and subacute postconcussion symptoms5 and acute physical and fatigue symptoms such as headache, sensitivity to noise, balance, and fatigue have been associated with PPCS 6,7. Premorbid factors8 such as somatic symptoms,9 migraine,6 preinjury cognitive ability,10 preexisting attention and mood concerns,11 anxiety,12 coping strategies,13 family functioning, and parental psychological adjustment14,15 have also been associated with PPCS. Premorbid conditions may impede recovery processes16 and exacerbate concussion and premorbid symptoms such as in mood and psychiatric disorders 17.…”

mentioning

confidence: 99%

Association Between Preinjury Symptoms and Postconcussion Symptoms at 4 Weeks in Youth

Ledoux

Tang

Gagnon

et al. 2021

Journal of Head Trauma Rehabilitation

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Objective: To investigate whether preinjury physical, emotional, cognitive, and sleep symptoms on the Post-Concussion Symptoms Inventory (PCSI) are associated with persistent postconcussion symptoms (PPCS) at 4 weeks and whether any associations are moderated by sex or age. Study Setting and Participants: A total of 3063 participants with acute concussion, presenting to 9 Canadian pediatric emergency departments, were enrolled from August 2013 to June 2015. Design: A planned secondary analysis of a prospective, multicenter cohort study (Predicting Persistent Post-concussive Problems in Pediatrics or 5P). Primary outcome was PPCS at 4 weeks, defined as 3 or more new or worsening individual symptoms compared with the preinjury score at 28 days on the PCSI. The association between preinjury scores and PPCS was analyzed with a multivariable logistic regression analysis that included preinjury, sex, age, sex × preinjury, and age × preinjury interactions as predictors. Missing baseline covariates were imputed. Results: A total of 2123 (n = 844 [39.8%] girls; median [IQR] age = 12.9 [10.7, 15.0] participants were included in the analysis. Preinjury physical symptom score was associated with PPCS at 4 weeks (χ 2 = 13.87, df = 6, P = .031). The preinjury emotional score also contributed to the variability in PPCS (χ 2 = 11.79, df = 6, P = .067). While girls reported higher preinjury physical, emotional, and cognitive scores than boys, neither sex nor age interacted with preinjury to predict PPCS at 4 weeks. Independent of age and sex, preinjury physical symptoms were associated with PPCS at 4 weeks (OR = 1.40; 95% CI, 1.15-1.70). Conclusion: Preinjury physical symptoms are associated with the probability of having PPCS at 4 weeks postconcussion independent of age and sex. Providers should consider preinjury symptoms to inform prognosis and recovery management.

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Predictors of Long-Term Psychosocial Functioning and Health-Related Quality of Life in Children and Adolescents With Prior Concussions

Abstract: Children's functioning before a concussion is critical to understanding outcome. Pre-injury attention and mood concerns should be assessed in clinical settings to prevent and treat long-term psychosocial problems after concussion. (JINS, 2018, 24, 540-548).

Cited by 28 publications

References 55 publications

Effects of Concussion in Adolescent Students: Perceptions and Performance

Effects of Concussion in Adolescent Students: Perceptions and Performance

Health-related quality of life following adolescent sports-related concussion or fracture: a prospective cohort study

Association Between Preinjury Symptoms and Postconcussion Symptoms at 4 Weeks in Youth

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