Predictors of Recovery from Pediatric Concussion

Concussion, or mild traumatic brain injury (mTBI), is a frequent cause of brain damage among youth and, therefore, represents a major public health problem. While most youth recover from concussion within 2 to 4 weeks, some concussed children and adolescents endure prolonged symptoms, along with mood disturbance sequelae for months. Few studies have assessed mood disturbance and concussion in pediatric populations. Additional research is necessary to understand pediatric concussion recovery and mood disturbance better, to guide early intervention efforts, and to improve pediatric concussion care. The purpose of this study was to examine how symptoms of mood disturbance (i.e., anxiety, depression, anger) and somatization relate to the odds of concussion recovery in male and female youth 12 to 17 years of age, who presented for neuropsychological evaluation after head injury. Significantly fewer females were deemed recovered at initial neuropsychological evaluation compared to males. Bivariate analyses of mood disturbance and somatization predictors revealed significant group differences in symptom burden between those determined recovered from concussion and those who had not recovered. Logistic regressions of each mood disturbance variable and somatization on concussion recovery suggested a modest decline in the odds of recovery as symptoms of mood disturbance or somatization increase. A multivariable logistic regression model of mood disturbance predictors, somatization, gender, and age was significant and explained over a quarter of the variance in concussion recovery; however, after a backward variable selection procedure, only depression and somatization symptoms were significant in the final model and accounted for a modest decline in the odds of concussion recovery at initial evaluation. Results replicate and extend research findings in pediatric concussion.