Childhood Mild Traumatic Brain Injury is Reliably Associated with Anxiety but Not Other Examined Psychiatric Outcomes at Two‐Year Follow‐up, After Adjusting for Prior Mental Health
Grace Revill, Norman Poole, Christina Carlisi, Anthony S. David, Vaughan Bell
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引用次数: 0
Abstract
BackgroundEvidence that mild traumatic brain injury (mTBI) causes psychiatric problems in children has been mixed. Investigating this issue has been difficult due to the lack of representative longitudinal data that includes adequate measures of mTBI, subsequent mental health symptoms and service use.MethodsWe used data from the ABCD longitudinal cohort study to examine the association between mTBI and psychiatric diagnoses, symptoms and psychiatric service use in over 11,000 children. In both children reporting (i) previous mTBI at baseline and (ii) previously uninjured children reporting new cases of mTBI since baseline, we examined psychiatric outcomes and service use at 2‐year follow‐up. We also compared mTBI cases to a comparison group of participants with orthopaedic injury but without mTBI. Mixed‐effects models were used and adjusted for demographic and social covariates, with missing data imputed using random forest multiple imputation. To account for baseline mental health, we used propensity‐score matching to identify a comparison sample matched on confounding variables and baseline outcome measures.ResultsWhen examined without adjustment for baseline mental health, both lifetime mTBI at baseline and new occurrence of mTBI at 2‐year follow‐up were reliably associated with an increased risk of DSM‐5 anxiety and behavioural disorders, a range of psychiatric symptom scores and increased service use. Controlling for baseline mental health in the mTBI group using propensity‐score matching eliminated all statistically reliable associations apart from anxiety disorder diagnosis and symptoms, which remain associated at 2‐year follow‐up. Evidence for association with medication use was inconsistent.ConclusionsConsistent evidence supporting an association between paediatric mTBI and subsequent anxiety was found; however, similar associations were not observed for other mental health outcomes. Regardless of potential causality, children with mTBI are likely to present with high levels of mental health difficulties, and this remains an important comorbidity that clinicians should be aware of.
期刊介绍:
The Journal of Child Psychology and Psychiatry (JCPP) is a highly regarded international publication that focuses on the fields of child and adolescent psychology and psychiatry. It is recognized for publishing top-tier, clinically relevant research across various disciplines related to these areas. JCPP has a broad global readership and covers a diverse range of topics, including:
Epidemiology: Studies on the prevalence and distribution of mental health issues in children and adolescents.
Diagnosis: Research on the identification and classification of childhood disorders.
Treatments: Psychotherapeutic and psychopharmacological interventions for child and adolescent mental health.
Behavior and Cognition: Studies on the behavioral and cognitive aspects of childhood disorders.
Neuroscience and Neurobiology: Research on the neural and biological underpinnings of child mental health.
Genetics: Genetic factors contributing to the development of childhood disorders.
JCPP serves as a platform for integrating empirical research, clinical studies, and high-quality reviews from diverse perspectives, theoretical viewpoints, and disciplines. This interdisciplinary approach is a key feature of the journal, as it fosters a comprehensive understanding of child and adolescent mental health.
The Journal of Child Psychology and Psychiatry is published 12 times a year and is affiliated with the Association for Child and Adolescent Mental Health (ACAMH), which supports the journal's mission to advance knowledge and practice in the field of child and adolescent mental health.