Brief cognitive behavioral interventions in mild traumatic brain injury

Postconcussion syndrome is a common and persisting consequence of mild traumatic head injury. The development of treatments for the syndrome has been hampered by a lack of consensus in diagnostic criteria, confusion about the relative contribution of psychological and neurologic etiological factors, and a paucity of controlled treatment outcome studies. In this article, we review the literature relevant to prevention and treatment of persisting postconcussive symptoms. Studies in adults and children suggest that although symptoms may initially have a neurologic basis, the syndrome persists because of psychological factors. Brief psychological treatment appears to significantly reduce the severity and duration of symptoms following mild head trauma. The attribution of persisting symptoms to organic factors conversely appears to be iatrogenic. Potentially useful diagnostic and treatment protocols are outlined.