Mild Traumatic Brain Injuries and Risk for Affective and Behavioral Disorders.

Autor:	Delmonico RL; Kaiser Foundation Rehabilitation Center, Kaiser Permanente Vallejo Medical Center, Vallejo, California.; The Permanente Medical Group, Oakland, California., Tucker LY; Division of Research, Kaiser Permanente, Oakland, California., Theodore BR; Kaiser Foundation Rehabilitation Center, Kaiser Permanente Vallejo Medical Center, Vallejo, California.; The Permanente Medical Group, Oakland, California., Camicia M; Kaiser Foundation Rehabilitation Center, Kaiser Permanente Vallejo Medical Center, Vallejo, California., Filanosky C; The Permanente Medical Group, Oakland, California.; Napa-Solano Sports Concussion Clinic, Kaiser Permanente Vacaville Medical Center, Vacaville, California., Haarbauer-Krupa J; Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
Jazyk:	angličtina
Zdroj:	Pediatrics [Pediatrics] 2024 Jan 01; Vol. 153 (2).
DOI:	10.1542/peds.2023-062340
Abstrakt:	Objectives: Recent studies document an association between mild traumatic brain injuries (mTBIs) in children and postinjury psychiatric disorders. However. these studies were subject to limitations in the design, lack of long-term follow-up, and poorly defined psychiatric outcomes. This study determines the incidence and relative risk of postinjury new affective and behavior disorders 4 years after mTBIs. Methods: A cohort study of mTBI cases and matched comparisons within an integrated health care system. The mTBI group included patients ≤17 years of age, diagnosed with mTBI from 2000 to 2014 (N = 18 917). Comparisons included 2 unexposed patients (N = 37 834) per each mTBI-exposed patient, randomly selected and matched for age, sex, race/ethnicity, and date of medical visit (reference date to mTBI injury). Outcomes included a diagnosis of affective or behavioral disorders in the 4 years after mTBI or the reference date. Results: Adjusted risks for affective disorders were significantly higher across the first 3 years after injury for the mTBI group, especially during the second year, with a 34% increase in risk. Adjusted risks for behavioral disorders were significant at years 2 and 4, with up to a 37% increase in risk. The age group with the highest risk for postinjury affective and behavioral disorders was 10- to 13-year-old patients. Conclusions: Sustaining an mTBI significantly increased the risks of having a new affective or behavioral disorder up to 4 years after injury. Initial and ongoing screening for affective and behavior disorders following an mTBI can identify persistent conditions that may pose barriers to recovery. (Copyright © 2024 by the American Academy of Pediatrics.)
Databáze:	MEDLINE
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