Concussion may increase risk of mental health problems in young people

March 10, 2022

2 minute read

Disclosures: Ledoux and Babikian do not report any relevant financial information. Please see the study for relevant financial information from all other authors.

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Concussion was linked to an increased risk of mental health problems, psychiatric hospitalization and self-harm in young people aged 5 to 18, according to results from a population-based retrospective cohort study.

“Few studies have rigorously examined the associations between concussion and the risk of psychopathology, new onset psychiatric disorders or long-term [mental health problems]”, Andree-Anne Ledoux, PhD, from the Children’s Hospital of Eastern Ontario Research Institute in Canada, and his colleagues wrote.

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“Studies that investigated these associations did not have an adequate sample size; had heterogeneous population samples, including [traumatic brain injuries]; or had few or no comparison groups.

“Some studies did not adjust for important covariates, such as [mental health problem]making it difficult to discern whether the concussions precipitated new mental health symptoms or psychiatric disorders.

Ledoux and colleagues aimed to examine the links between concussion and the risk of later mental health problems, psychiatric hospitalizations, self-harm or suicide in young people who had suffered a concussion or an orthopedic injury that occurred between the 1st April 2010 and March 31, 2020 in Ontario. Participants had no prior mental health visit in the year prior to the index event, as well as no prior concussions or head injuries in the 5 years prior to the index visit.

The researchers collected data from provincial health administrative databases and included participants with a concussion (n=152,321; median age, 13 years; 56.7% male) in the group exposed and those with an orthopedic injury (n = 296,482; median age, 13 years; 57.9 years). % male) in the comparison cohort.

The researchers matched these groups in a 1:2 ratio, respectively, by age and gender. Mental health problems, including psychopathologies and psychiatric disorders, identified during health care visits to emergency departments, hospitalizations, or primary care settings served as the primary outcome measure. Psychiatric hospitalizations, health care visits for self-harm, and suicide deaths served as secondary outcomes.

The results showed incidence rates of any mental health problem of 11,141 per 100,000 person-years in the exposed group compared to 7,960 per 100,000 person-years in the unexposed group, with a difference of 3 181 (95% CI, 3073-3291) per 100,000 people. -years.

Among the exposed group, the researchers noted an increased risk of developing a mental health problem (adjusted HR = 1.39; 95% CI, 1.37-1.4), self-harm (aHR = 1.49 95% CI, 1.42-1.56) and psychiatric hospitalization (aHR = 1.47; 95% CI, 1.41-1.53) after concussion. They found no statistically significant difference in suicide deaths between exposed and unexposed groups (HR=1.54; 95% CI, 0.9-2.61).

“Our findings suggest that clinicians should assess pre-existing and new mental health symptoms throughout concussion recovery; treat mental health problems or symptoms or refer the patient to a pediatric mental health specialist; and assess suicidal ideation and self-harming behaviors during assessment and follow-up visits for concussion,” Ledoux and colleagues wrote.

In a related editorial, talin BabikianPhD, ABPP, from the Department of Psychiatry and Biobehavioral Sciences at the University of California, Los Angeles, highlighted takeaways from this study.

“When drawing on the literature on risk and protective factors associated with mental health, powerful common denominators that seep to the top and have strong relevance in the management of concussions include a sense of safety and agency and a sense of connection and belonging,” Babikian wrote. “Studies, such as the one presented by Ledoux et al, strengthen the association between mental health and concussion – and likely any other major disturbance in a young person’s physiology and environment. The good news is that we recognize this risk and are paying attention to it. »

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