Psychiatric outcomes after mild concussion by treatment timing and age

IF 3.7 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research Pub Date : 2025-05-08 DOI:10.1016/j.jpsychires.2025.05.017

Austin A. Kennemer , Zhenxiang Gao , Lindsey Wang , Pamela B. Davis , David C. Kaelber , Rong Xu

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Abstract

Previous guidance for mild concussion treatment has recommended physical and cognitive rest. However, it remains unknown if patients who received treatment at different times had differential neuropsychiatric outcomes. We examined if patients who received immediate treatment less than one week after a mild concussion had a different risk for subsequent depression or anxiety compared with those who received delayed treatment greater than one week after the event, stratified by age groups. This multicenter retrospective cohort study used the TriNetX Analytics platform to access de-identified electronic health records of over 100 million patients, including both inpatient and outpatient visits, from 60 healthcare organizations across the United States. A total of 9881 patients with a diagnosis of mild concussion either received either immediate treatment, defined as within 1 week (n = 4053), or delayed treatment, defined as 1 week to 6 months (n = 5828) following the diagnosis of mild concussion.

Each group was stratified by age:≤25, 26–64, and 65+ years. Patients who received early treatment had significantly lower risk of depression and anxiety compared with propensity-score matched patients who received delayed treatment during a 5-year follow-up after mild TBI diagnosis, with hazard ratios (HRs) of 0.74 (95 % CI, 0.65–0.84) and 0.75 (95 % CI, 0.68–0.84), respectively. These results are consistent across age groups, with strongest reduction in older adults aged 65 years and older. These findings suggest that timely treatment for concussion may mitigate subsequent adverse psychiatric outcomes.

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轻度脑震荡后的精神预后与治疗时间和年龄的关系

先前的轻度脑震荡治疗指南建议进行身体和认知休息。然而，在不同时间接受治疗的患者是否有不同的神经精神结果仍不清楚。我们对轻度脑震荡后在一周内接受立即治疗的患者与在事件发生后一周以上接受延迟治疗的患者进行了分层研究，以确定其随后抑郁或焦虑的风险是否不同。这项多中心回顾性队列研究使用TriNetX Analytics平台访问来自美国60个医疗保健组织的1亿多名患者的去识别电子健康记录，包括住院和门诊就诊。共有9881名诊断为轻度脑震荡的患者接受了立即治疗，定义为1周内（n = 4053），或延迟治疗，定义为1周至6个月（n = 5828）。各组按年龄分层：≤25岁、26-64岁、65岁以上。在轻度TBI诊断后的5年随访中，接受早期治疗的患者与接受延迟治疗的倾向评分匹配的患者相比，抑郁和焦虑的风险显著降低，风险比（hr）分别为0.74 （95% CI, 0.65-0.84）和0.75 （95% CI, 0.68-0.84）。这些结果在各个年龄组中都是一致的，65岁及以上的老年人的下降幅度最大。这些发现表明，及时治疗脑震荡可以减轻随后的不良精神后果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of psychiatric research 医学-精神病学

CiteScore

7.30

自引率

2.10%

发文量

622

审稿时长

130 days

期刊介绍： Founded in 1961 to report on the latest work in psychiatry and cognate disciplines, the Journal of Psychiatric Research is dedicated to innovative and timely studies of four important areas of research: (1) clinical studies of all disciplines relating to psychiatric illness, as well as normal human behaviour, including biochemical, physiological, genetic, environmental, social, psychological and epidemiological factors; (2) basic studies pertaining to psychiatry in such fields as neuropsychopharmacology, neuroendocrinology, electrophysiology, genetics, experimental psychology and epidemiology; (3) the growing application of clinical laboratory techniques in psychiatry, including imagery and spectroscopy of the brain, molecular biology and computer sciences;