A new study discloses that around 1 in 5 people may suffer mental health problems up to six months following mild traumatic brain injury (mTBI), indicating the significance of follow-up care for these people. Researchers also determined elements that could raise the chance of developing post-traumatic stress disorder (PTSD) and/or major depressive disorder after mild mTBI or concussion through evaluation of the ‘Transforming Research and Clinical Knowledge in Traumatic Brain Injury’ (TRACK-TBI) study cohort. The research was backed by the National Institute of Neurological Disorders and Stroke (NINDS), a portion of the National Institutes of Health. The results were released in JAMA Psychiatry.
“Mental health disorders after concussion have been studied primarily in military populations, and not much is known about these outcomes in civilians,” said Patrick Bellgowan, Ph.D., NINDS program director. “These results may help guide follow-up care and suggest that doctors may need to pay particular attention to the mental state of patients many months after injury.”
In the research, Murray B. Stein, M.D., M.P.H., an expert at the University of California San Diego, along with his colleagues researched mental health results in 1,155 people who’d experienced a minor TBI and had been cared for in the emergency department. At three, six, and 12 months following damage, study members performed a variety of surveys relating to PTSD and major depressive disorder. For a comparison group, the scientists also questioned those who had encountered orthopedic traumatic injuries, including, broken legs but was without head injury.
The end result revealed that at three and six months after injury, individuals who had undergone mTBI were more inclined than orthopedic trauma patients to document signs of PTSD and/or major depressive disorder. For instance, 3 months after injury, 20 percent of mTBI individuals noted mental health symptoms as compared to 8.7 percent of orthopedic trauma patients. At 6 months following injury, mental health symptoms were reported by 21.2 percent of individuals who had encountered head injury and 12.1 percent of orthopedic trauma patients.
Dr. Stein and his team also utilized the information to work out risk factors for PTSD and major depressive disorder after mTBI. The results disclosed that lower levels of education, self-identifying as African-American, and suffering from a past of mental illness enhanced risk. Additionally, if the head injury was as a result of an assault or other violent attacks, that increased the likelihood of developing PTSD, but not major depressive disorder. Nonetheless, risk of mental health signs was not linked to other injury-related incidents for example duration of loss of consciousness or posttraumatic amnesia.
“Contrary to common assumptions, mild head injuries can cause long-term effects. These findings suggest that follow-up care after a head injury, even for mild cases, is crucial, especially for patients showing risk factors for PTSD or depression,” said Dr. Stein.
This study falls under the NIH-funded TRACK-TBI effort, which is a sizable, long-term study of individuals treated in the emergency department for mTBI. The intention of the research is to further improve understanding of the consequences of concussions by creating a complete database of clinical measures which includes brain images, blood samples, and result data for 3,000 individuals, which can help recognize biomarkers of TBI, risk factors for various outcomes, and increase our capacity to identify and prevent negative results of head injury. Currently, more than 2,700 participants have listed in TRACK-TBI.
A current study emerging from TRACK-TBI recommended a large number of TBI patients were never receiving suggested follow-up care.
“TRACK-TBI is overturning many of our long-held beliefs around mTBI, particularly in what happens with patients after they leave the emergency department. We are seeing more evidence about the need to monitor these individuals for many months after their injury to help them achieve the best recovery possible,” said Geoff Manley, M.D., professor at the University of California San Francisco, senior writer of the present study and key investigator of TRACK-TBI.
Upcoming scientific studies will assist with identifying mental health issues, apart from PTSD and major depressive disorder, that could perhaps develop following mTBI. Additionally, more studies are required to grasp the biological mechanisms that lead from mTBI to mental health problems and various other negative outcomes, including neurologic and cognitive challenges.