Children who sustain a mild traumatic brain injury (mTBI) have an increased risk of affective and behavioral disorders and should be monitored, according to a new study.
“Identifying and treating these mental health disorders could reduce the impact and burden associated with multifactorial challenges of mTBI,” authors wrote. “These findings show that mTBI may have a pronounced mental health impact on middle- and high school-age children.”
Researchers studied data from an integrated health care system based in Northern California. The study included nearly 19,000 children under 18 years diagnosed with mTBI including concussion from 2000 to 2014. Each child was matched with two patients based on age, sex, race/ethnicity and having a medical visit in the same month but who had not sustained an mTBI.
In the four years after injury, children with mTBI were 25% more likely to be diagnosed with an affective disorder like depression, anxiety or an adjustment disorder compared to the group without mTBI, according to “Mild Traumatic Brain Injuries and Risk for Affective and Behavioral Disorders” (Delmonico RL, et al. Pediatrics. Jan. 25, 2024).
The risk was statistically significant for children 10 years and older. Two years after injury, children ages 10-13 years were 48% more likely to be diagnosed with an affective disorder than their peers, according to the study.
Researchers also found children with mTBI were 18% more likely to be diagnosed with a behavioral disorder like attention-deficit/hyperactivity disorder (ADHD), conduct disorder or oppositional defiant disorder within four years of their injury. There was a 37% increased risk in year four. The risk was significant only for children ages 10-13 years, a group that was 50% more likely to be diagnosed within two years than children without mTBI.
While risk of behavioral disorders increased after mTBI, authors noted conduct disorder and oppositional defiant disorder they still were rare.
They called for ongoing assessments following an mTBI, especially for children ages 10 years and older to “identify persistent conditions that may pose barriers to recovery.”
Resources
- AAP clinical report Sport-Related Concussion in Children and Adolescents
- CDC pediatric mTBI guideline
- CDC HEADS UP materials on concussions aimed at parents, providers, coaches and schools
- Information for parents from HealthyChildren.org about concussions
