Mild brain injuries associated with mental, behavioral issues in children
Click Here to Manage Email Alerts
Key takeaways:
- Post-injury depressive disorders were 17% more likely in children with mild brain injury.
- Children with mild brain injuries were 25% more likely to be diagnosed with an affective disorder.
Mild traumatic brain injuries may raise the risk for affective and behavioral disorders in children, according to research published in Pediatrics.
Mild traumatic brain injuries (mTBIs) can occur in sports or from a fall, and represent at least 75% of all traumatic brain injuries annually, according to the researchers.
“In a previous study of mTBI, we found that 42% of patients with an mTBI diagnosis in our system were under 18,” Richard Delmonico, PhD, director of neuropsychology at the Kaiser Foundation Rehabilitation Center in Vallejo, California, told Healio. “While our first published paper focused on the adult population, we made it a priority to investigate the pediatric population as our next step in our research on psychological disorders following mTBI.”
Delmonico and colleagues identified patients aged 17 years or younger who were seen in the Kaiser Permanente health care system between 2011 and 2014 for a primary diagnosis of mTBI. Any remaining patients were included as controls.
“We then reported incidence rates, such as new psychological disorders occurring post-injury, and calculated adjusted risk ratios to compare the effect of mTBI on post-injury mood and behavioral disorders, compared to noninjured controls,” Brian Theodore, PhD, research scientist at the Kaiser Foundation Rehabilitation Center, told Healio.
In all, they examined the electronic health records of 18,917 children and compared the groups by mental health issues occurring within 4 years following the incident.
Ultimately, patients with mTBIs were 25% more likely to be diagnosed with an affective disorder, which included depression, anxiety, post-traumatic stress disorder and acute stress.
Post-injury depressive disorders were 17% more likely among patients with mTBI, particularly in children aged 10 to 13 years, who were over 40% more likely to be diagnosed with depression within 2 years. For anxiety disorders, those with mTBIs were 14% more likely to be diagnosed as anxious. Children aged 10 to 13 years were again at higher risk, with 42% more likely to have anxiety disorders 2 years after injury.
“These results highlight the importance of regular interval screening for affective and behavioral disorders in children who sustain a mild TBI over at least 2 years post-injury,” Delmonico said.
The authors concluded that children are at an elevated risk of developing mental and behavioral health issues following an mTBI, particularly those aged 10 to 13 years, who had the highest risk for developing depressive, anxiety and adjustment disorders.
Theodore said the team recently concluded a study investigating the impact of the COVID-19 pandemic on children who sustained mTBI just before the pandemic, with an aim of determining the pandemic’s impact on the “development of psychological disorders and related health care utilization for treating those with these diagnoses.”
“With school closures, remote learning, lack of social contact and the general stress related to pandemic restrictions, our hypothesis was that the incidence of mood and behavioral disorders would be significantly higher than our historical rates observed in the present study,” Theodore said.
“It will be important to start considering studies focused on implementation science that are designed for early identification of risks that can be addressed before it becomes a chronic psychological disorder,” Delmonico said.
Collapse
Click Here to Manage Email Alerts