Interview versus questionnaire symptom reporting in people with the postconcussion syndrome

Area of Science:

• Neuroscience
• Clinical Psychology
• Rehabilitation Medicine

Background:

• Mild traumatic brain injury (mTBI) can lead to persistent postconcussion symptoms.
• Accurate symptom assessment is crucial for effective concussion management.
• Standardized questionnaires are commonly used but may not fully capture patient experiences.

Purpose of the Study:

• To compare spontaneous symptom reporting during interviews with symptom endorsement on a standardized questionnaire.
• To investigate discrepancies in symptom reporting following mild traumatic brain injury.

Main Methods:

• Sixty-one patients with mTBI referred to a concussion clinic were studied.
• Symptoms were assessed through open-ended interviews and the British Columbia Postconcussion Symptom Inventory (BC-PSI).

Main Results:

• Patients reported an average of 3.3 symptoms in interviews versus 9.1 on the BC-PSI.
• Symptom endorsement was significantly higher on the BC-PSI for all items.
• Many patients endorsed moderate-to-severe symptoms on the BC-PSI without reporting them spontaneously in interviews.

Conclusions:

• Questionnaire-based symptom reporting may overestimate symptom prevalence and severity after mTBI.
• Clinicians should consider potential overendorsement, symptom expectations, and nocebo effects when interpreting standardized concussion assessments.