Preinjury somatization symptoms contribute to clinical recovery after sport-related concussion. Neurology 2016 May 17;86(20):1856-63
Date
05/11/2016Pubmed ID
27164666Pubmed Central ID
PMC4873681DOI
10.1212/WNL.0000000000002679Scopus ID
2-s2.0-84969255706 (requires institutional sign-in at Scopus site) 120 CitationsAbstract
OBJECTIVE: To determine the degree to which preinjury and acute postinjury psychosocial and injury-related variables predict symptom duration following sport-related concussion.
METHODS: A total of 2,055 high school and collegiate athletes completed preseason evaluations. Concussed athletes (n = 127) repeated assessments serially (<24 hours and days 8, 15, and 45) postinjury. Cox proportional hazard modeling was used to predict concussive symptom duration (in days). Predictors considered included demographic and history variables; baseline psychological, neurocognitive, and balance functioning; acute injury characteristics; and postinjury clinical measures.
RESULTS: Preinjury somatic symptom score (Brief Symptom Inventory-18 somatization scale) was the strongest premorbid predictor of symptom duration. Acute (24-hour) postconcussive symptom burden (Sport Concussion Assessment Tool-3 symptom severity) was the best injury-related predictor of recovery. These 2 predictors were moderately correlated (r = 0.51). Path analyses indicated that the relationship between preinjury somatization symptoms and symptom recovery was mediated by postinjury concussive symptoms.
CONCLUSIONS: Preinjury somatization symptoms contribute to reported postconcussive symptom recovery via their influence on acute postconcussive symptoms. The findings highlight the relevance of premorbid psychological factors in postconcussive recovery, even in a healthy athlete sample relatively free of psychopathology or medical comorbidities. Future research should elucidate the neurobiopsychosocial mechanisms that explain the role of this individual difference variable in outcome following concussive injury.
Author List
Nelson LD, Tarima S, LaRoche AA, Hammeke TA, Barr WB, Guskiewicz K, Randolph C, McCrea MAAuthors
Michael McCrea PhD Professor in the Neurosurgery department at Medical College of WisconsinLindsay D. Nelson PhD Associate Professor in the Neurosurgery department at Medical College of Wisconsin
Sergey S. Tarima PhD Associate Professor in the Institute for Health and Equity department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AnxietyAthletic Injuries
Depression
Female
Humans
Incidence
Longitudinal Studies
Male
Models, Biological
Multivariate Analysis
Post-Concussion Syndrome
Proportional Hazards Models
Psychiatric Status Rating Scales
Regression Analysis
Schools
Self Report
Somatoform Disorders
Time Factors
Treatment Outcome
Universities
