Research Reports - Psychosocial consequences of mild traumatic brain injury in children

Arch Phys Med Rehabil. 2014 Mar;95

Keightley ML(1), Côté P(2), Rumney P(3), Hung R(3), Carroll LJ(4), Cancelliere C(5), Cassidy JD(6)

OBJECTIVE: To synthesize the best available evidence regarding psychosocial
consequences of mild traumatic brain injury (MTBI) in children.
DATA SOURCES: MEDLINE, Embase, CINAHL, PsycINFO, and SPORTDiscus were searched
(2001-2012). Inclusion criteria included published peer-reviewed reports in
English, French, Norwegian, Spanish, Swedish, and Danish. References were also
identified from relevant reviews and meta-analyses, and the bibliographies of
eligible articles.
STUDY SELECTION: This article presents an update of a previous review with a much
larger scope, of which this topic is a small subset of the questions addressed by
that review. Controlled trials and cohort and case-control studies were selected
according to predefined criteria. Two independent reviewers used modified
Scottish Intercollegiate Guidelines Network criteria to critically appraise
eligible studies. A total of 77,914 records were screened; 101 of these articles
were deemed scientifically admissible, of which 6 investigated the psychosocial
consequences of MTBI in children.
DATA EXTRACTION: Two reviewers independently extracted data from accepted studies
into evidence tables.
DATA SYNTHESIS: We conducted a best-evidence synthesis by linking our conclusions
to the evidence tables. Most accepted studies were exploratory rather than
confirmatory. Preliminary evidence suggests that most children recover within 3
months post-MTBI. After 1 year, the prevalence of postconcussion symptoms and
syndrome is similar between children with MTBI and children with orthopedic
injuries. The functional status of children with MTBI improves over a 30-month
follow-up period, but further research is needed to investigate the possibility
that children with MTBI experience greater rates of psychiatric illness during
the 3 years after their injury.
CONCLUSIONS: The prognosis of MTBI is favorable in children. Most appear to
recover functionally from a physical and psychological perspective. However,
future research should investigate the risk for psychiatric illness.

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