Early Behavior After Head Trauma Predicts Postconcussional Syndrome

PARIS – Patients with mild traumatic brain injury who reported all or nothing behavior were significantly more likely to have postconcussional syndrome 3 months later, data from a prospective study of 107 adults have shown.

Approximately 15%-30% of mild traumatic brain injury (MTBI) patients are at risk of developing postconcussional syndrome (PCS), Dr. Ruihua Hou of the University of Southampton (England) explained at the annual meeting of the European Congress of Neuropsychopharmacology.

PCS is a symptom cluster that includes physical, cognitive, emotional, and behavioral symptoms. To investigate the etiology of PCS, the researchers developed a cognitive-behavioral model that compared MTBI patients who did and did not develop the syndrome.

Patients were assessed for cognitive, behavioral, emotional, and social variables at baseline using the Brief Illness Perception Questionnaire, the Behavioral Responses to Illness Questionnaire, the Impact of Events Scale, the Hospital Anxiety and Depression Scale, the Anxiety Sensitivity Index, and the Brief Social Support Questionnaire.

At the 3- and 6-month follow-up visits, the researchers used the Rivermead Post-Concussion Symptoms Questionnaire to assess the severity of PCS symptoms and the ICD-10 code F07.2 to diagnose PCS.

All or nothing behavior shortly after MTBI was a significant predictor for the onset of PCS at 3 months (odds ratio, 1.141).

However, all or nothing behavior was not a significant predictor of PCS after 6 months, the researchers noted. Instead, patients’ early negative injury perception was a significant predictor of the onset of PCS after 6 months (odds ratio, 1.053).

At 3 months and 6 months, no significant differences were observed between PCS cases and noncases with regard to demographics, including age, sex, education level, and occupation.

Although the findings were limited by the prospective nature of the study, they provide support for the cognitive model that was used, Dr. Hou said.

In addition, "the findings provide research evidence for the role of illness perception and coping behavior shortly after MTBI in the development of PCS and indicate that they may be important early-intervention targets," Dr. Hou emphasized.

The study was funded by the Faculty of Medicine Research Management Committee at the University of Southampton. The researchers said they had no relevant financial disclosures.

PARIS – Patients with mild traumatic brain injury who reported all or nothing behavior were significantly more likely to have postconcussional syndrome 3 months later, data from a prospective study of 107 adults have shown.

Approximately 15%-30% of mild traumatic brain injury (MTBI) patients are at risk of developing postconcussional syndrome (PCS), Dr. Ruihua Hou of the University of Southampton (England) explained at the annual meeting of the European Congress of Neuropsychopharmacology.

PCS is a symptom cluster that includes physical, cognitive, emotional, and behavioral symptoms. To investigate the etiology of PCS, the researchers developed a cognitive-behavioral model that compared MTBI patients who did and did not develop the syndrome.

Patients were assessed for cognitive, behavioral, emotional, and social variables at baseline using the Brief Illness Perception Questionnaire, the Behavioral Responses to Illness Questionnaire, the Impact of Events Scale, the Hospital Anxiety and Depression Scale, the Anxiety Sensitivity Index, and the Brief Social Support Questionnaire.

At the 3- and 6-month follow-up visits, the researchers used the Rivermead Post-Concussion Symptoms Questionnaire to assess the severity of PCS symptoms and the ICD-10 code F07.2 to diagnose PCS.

All or nothing behavior shortly after MTBI was a significant predictor for the onset of PCS at 3 months (odds ratio, 1.141).

However, all or nothing behavior was not a significant predictor of PCS after 6 months, the researchers noted. Instead, patients’ early negative injury perception was a significant predictor of the onset of PCS after 6 months (odds ratio, 1.053).

At 3 months and 6 months, no significant differences were observed between PCS cases and noncases with regard to demographics, including age, sex, education level, and occupation.

Although the findings were limited by the prospective nature of the study, they provide support for the cognitive model that was used, Dr. Hou said.

In addition, "the findings provide research evidence for the role of illness perception and coping behavior shortly after MTBI in the development of PCS and indicate that they may be important early-intervention targets," Dr. Hou emphasized.

The study was funded by the Faculty of Medicine Research Management Committee at the University of Southampton. The researchers said they had no relevant financial disclosures.

PARIS – Patients with mild traumatic brain injury who reported all or nothing behavior were significantly more likely to have postconcussional syndrome 3 months later, data from a prospective study of 107 adults have shown.

Approximately 15%-30% of mild traumatic brain injury (MTBI) patients are at risk of developing postconcussional syndrome (PCS), Dr. Ruihua Hou of the University of Southampton (England) explained at the annual meeting of the European Congress of Neuropsychopharmacology.

PCS is a symptom cluster that includes physical, cognitive, emotional, and behavioral symptoms. To investigate the etiology of PCS, the researchers developed a cognitive-behavioral model that compared MTBI patients who did and did not develop the syndrome.

Patients were assessed for cognitive, behavioral, emotional, and social variables at baseline using the Brief Illness Perception Questionnaire, the Behavioral Responses to Illness Questionnaire, the Impact of Events Scale, the Hospital Anxiety and Depression Scale, the Anxiety Sensitivity Index, and the Brief Social Support Questionnaire.

At the 3- and 6-month follow-up visits, the researchers used the Rivermead Post-Concussion Symptoms Questionnaire to assess the severity of PCS symptoms and the ICD-10 code F07.2 to diagnose PCS.

All or nothing behavior shortly after MTBI was a significant predictor for the onset of PCS at 3 months (odds ratio, 1.141).

However, all or nothing behavior was not a significant predictor of PCS after 6 months, the researchers noted. Instead, patients’ early negative injury perception was a significant predictor of the onset of PCS after 6 months (odds ratio, 1.053).

At 3 months and 6 months, no significant differences were observed between PCS cases and noncases with regard to demographics, including age, sex, education level, and occupation.

Although the findings were limited by the prospective nature of the study, they provide support for the cognitive model that was used, Dr. Hou said.

In addition, "the findings provide research evidence for the role of illness perception and coping behavior shortly after MTBI in the development of PCS and indicate that they may be important early-intervention targets," Dr. Hou emphasized.

The study was funded by the Faculty of Medicine Research Management Committee at the University of Southampton. The researchers said they had no relevant financial disclosures.