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Overlooked Concussion in Children May Cause Mental Health Comorbidities
Among US children who show significant symptoms after a head injury, 23% are not evaluated for concussion or brain trauma. These children are also more likely to experience mental and social disturbances, such as depressive symptoms, and require mental health services. Researchers who published their findings in the journal Brain Injury suggest that routine concussion evaluation should be emphasized, especially in younger children.
Lead researcher, Priyanka Ramulu, along with Samir Belagaje, MD, of Emory University School of Medicine in Atlanta, and Varshini Varadaraj, MD, MPH, MS, MBBS, of Johns Hopkins University in Baltimore said, “We studied the connection between past head trauma and current mental and social well-being with children included in the 2020 National Health Interview Survey (NHIS). By using this sample, we are more likely to capture the impact of head trauma in a broader population of children, not simply children presenting for care.”
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While ample research has examined the long-term effects of concussions and brain injuries in adults, Ramalu and co-authors set out to elucidate the impacts on children using data collected as part of the representative cross-sectional NHIS. Their research builds off of a 2020 study which revealed that 6.8% of children under the age of 17 have been diagnosed with a concussion or brain injury, which can significantly impact their mental and social health.
Amongst the US children ages 5-17 years included in the study, 8.7% had previous symptoms of a concussion or brain injury, and 5.3% had received a formal diagnosis. Of children with symptoms, 23% were never checked for a concussion/brain injury, with younger children at higher risk of not getting checked after symptomatic head trauma. Prior concussion or brain injury symptoms or diagnosis was associated with a higher likelihood of current depressive symptoms (odds ratio [OR] = 1.60; 95% CI = 1.21–2.14; p < 0.001), anxiety (OR = 2.07; 95% CI = 1.52–2.82; p < 0.001), difficulty making friends (OR = 1.57; 95% = 1.06–2.33; p = 0.03), use of medications for mental/social/behavioral issues (OR = 1.69; CI = 1.21–2.36; p = 0.002), and mental health therapy/counseling (OR = 1.52; 95% CI = 1.13–2.04; p = 0.006).
Both concussive and brain injury symptoms or diagnosis had similar, significant effects on current mental and social health including (1) depressive symptoms, (2) anxiety, (3) use of medication for concentration, mental health, behavior, or emotions, and (4) therapy/counseling for mental health.
Researchers wrote they hope their study displays “the need to ensure that all children experiencing head trauma are evaluated for a concussion/brain injury, even in the absence of significant concussion/brain injury symptoms (vomiting, loss of consciousness, mood change, vision loss, and memory loss), due to the detrimental effects of a second head trauma.” They also urged for “the children and their families [to] have proper resources to address the mental and social repercussions head trauma might produce.”
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