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Somatic Symptom Disorder After Mild Traumatic Brain Injury
Noah D Silverberg1, Mathilde Rioux, Ana Mikolić
1Author Affiliations: Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada (Dr Silverberg, Ms Rioux, Dr Mikolić); Rehabilitation Research Program, Centre for Aging SMART, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada (Dr Silverberg); Djavad Mowafaghian Centre for Brain Health, Vancouver, British Columbia, Canada(Dr Silverberg); Erasmus MC University Medical Centre, Rotterdam, The Netherlands (Dr Mikolić); Mass General Brigham Integrated Healthcare System, Massachusetts General Hospital, Departments of Neurology and Psychiatry, Harvard Medical School, Boston, Massachusetts (Dr Perez); Neuropsychiatry Program, Department of Psychiatry and Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada (Dr Burke); Hurvitz Brain Sciences Program and Tory Trauma Program, Sunnybrook Research Institute, Toronto, Ontario, Canada (Dr Burke); British Columbia Neuropsychiatry Program, Vancouver, British Columbia, Canada (Dr Howard); and Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada (Dr Howard).
Somatic Symptom Disorder (SSD) affects up to 27% of mild traumatic brain injury (mTBI) patients, leading to more pain, distress, and disability. Early illness beliefs predict SSD, highlighting the need for timely identification and intervention for better mTBI outcomes.
Area of Science:
- Neuroscience
- Psychiatry
- Public Health
Background:
- Mild traumatic brain injury (mTBI) is frequently linked to persistent somatic symptoms.
- Somatic Symptom Disorder (SSD) may be a common consequence of mTBI, impacting long-term recovery.
- Understanding the prevalence and predictors of SSD after mTBI is crucial for effective patient management.
Purpose of the Study:
- To determine the prevalence of Somatic Symptom Disorder (SSD) in adults following mild traumatic brain injury (mTBI).
- To investigate the correlates, predictors, and functional impact of SSD at 6 months post-mTBI.
- To examine the association between early illness beliefs and the development of SSD after mTBI.
Main Methods:
- A cohort of 476 adults with mTBI was followed up from emergency departments and urgent care centers.
- Secondary analysis of a clinical trial data, assessing illness beliefs (~2 weeks post-mTBI) and outcomes at 6 months.
- Validated scales were used to measure SSD symptoms (SSD-12), post-concussion symptoms (RPQ), disability (WHODAS), and psychiatric diagnoses (MINI).
Main Results:
- The prevalence of SSD at 6 months post-mTBI ranged from 15% to 27%.
- SSD was associated with increased pain, post-concussion symptoms, Major Depressive Disorder (OR=9.1), and anxiety disorders (OR=5.6).
- Early beliefs about mTBI's serious consequences and distress predicted later SSD; SSD symptoms predicted functional disability (WHODAS).
Conclusions:
- Somatic Symptom Disorder (SSD) significantly increases symptom burden, comorbidity, and disability following mild traumatic brain injury (mTBI).
- Early identification of individuals at risk for SSD post-mTBI is feasible and essential.
- SSD provides a valuable framework for understanding poor outcomes in mTBI patients with psychological distress and guiding rehabilitation strategies.
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