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Mild traumatic brain injury related to increased risk of post-traumatic stress disorder and depression



Specifically, the research links mild traumatic brain injury with an increased risk of post-traumatic stress disorder and depression after injury, compared with another type of traumatic injury that does not involve the head.

The study, published Wednesday in the medical journal JAMA Psychiatry, found that among hospital patients, 21.2% of people with mild traumatic brain injuries experienced PTSD or depression up to six months after the injury, compared with 12.1% of people with non-cranial lesions.
A traumatic brain injury can range from "mild" to "severe" and is usually caused by a blow, blow or jolt to the head or a penetrating head injury that interrupts normal brain function, according to the Centers for Disease Control. Diseases of the USA UU and Prevention.

The new study included 1,155 patients with mild traumatic brain injuries and 230 with non-traumatic head injuries from 11 hospitals with trauma centers in the United States, between 2014 and 2016.

Among the mild traumatic brain injuries, 61.8% was due to a motor vehicle collision, 29.2% was due to a fall or other unintentional injury, 6.1% was due to violence or aggression and 3% was due to a unspecified cause.

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The health of each patient was evaluated shortly after being treated in the hospital, two weeks later and three months, six months and 12 months after the injury. At these points, patients were evaluated for the symptoms of post-traumatic stress disorder and major depressive disorder.

The researchers found that patients with mild traumatic brain injury were more likely to have PTSD or major depressive symptoms at three and six months after the injury. At three months, for example, the prevalence of mild depressive disorder or PTSD was 20% among people with mild traumatic brain injury, compared to 8.7% among people with non-cranial injuries.

The researchers also found that having a mental health problem before a traumatic brain injury was "an exceptionally strong risk factor" for having PTSD or major depressive disorder later.

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The study had some limitations, including that more research is needed before the findings can be generalized to other hospitals, communities or countries. In addition, the researchers relied on personal reports on patients' history of mental health problems.

The researchers also found an increased risk of post-traumatic stress disorder and depression after a mild traumatic brain injury among black patients. More research is needed to analyze this disparity.

In general, "our findings may have implications for the surveillance and treatment of mental disorders after a TBI.The emergence and long-term course of PTSD after TBI are variable," the researchers wrote.

Their findings show that posttraumatic stress disorder and major depressive disorder, although common, occur only in a minority of patients after a mild traumatic brain injury, "but especially in those with previous mental health problems," they wrote.

The research was supported by the National Institutes of Health and the Department of Defense of the United States. However, the researchers also included a long list of disclosures of conflicts of interest, including some pharmaceutical companies and the NFL.
Dr. John Leddy, a primary care sports medicine physician and clinical professor at the University of Buffalo in New York, called the new study "well done," but noted that the findings can not be generalized to sports-related concussions. .

"Mild traumatic brain injury is a category of bran injury that includes concussion, with concussion at the softer end of that spectrum." Therefore, sports concussion would be a subset of mild traumatic brain injury, "said Leddy. , who was not involved in the study, but serves as medical director of the Concussion Management Clinic at the University of Buffalo.

"All of the patients in this study received a CT scan to evaluate a brain hemorrhage or a skull fracture and may have had a neurological deficit when they went to the emergency room, although that type of injury can be classified as & # 39; mild, "is a much more serious than what would normally be a sports-related concussion," he said.

"Overall, I think it's a good study to help predict who is at risk for depression and post-traumatic stress disorder (PTSD) after a traumatic brain injury suffered in a car accident or an assault," He said, "but the results can not be generalized to athletes with a concussion."


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