Abstract for presentation at 6th World Congress on Brain Injury

Psychological OutcomeS and its Determinants One and Six Months after Injury in Severe, Moderate and Mildly Head Injured Children

  • Ms Helen Miller, Kids Head Injury Study, Frenchay Hospital & University of Bristol, United Kingdom
  • Ms Renee McCarter, Kids Head Injury Study, Frenchay Hospital, Bristol, United Kingdom
  • Dr Andrew Curran, Kids Head Injury Study, Frenchay Hospital, Bristol, United Kingdom
  • Dr Linda Hunt, Institute of Child Health, Bristol, United Kingdom
  • Dr Peta Sharples, Kids Head Injury Study, Frenchay Hospital & Bristol Children's Hospital and Institue of Child Health, United Kingdom

    • Introduction: Pediatric traumatic brain injury (TBI) is a major cause of hospital admission. TBI results in cognitive sequelae but few data exist concerning psychological outcome.
    Aims: To define psychological outcome in TBI admissions at 1 and 6 months after injury compared with uninjured controls; to explore factors related to poor psychological outcome.
    Methods: Prospective cohort study. TBI was classed by admission Glasgow Coma Score; Psychological response assessed by the Birelson Depression Scale (BDS), Impact of Events Scale (IES), Revised Children's Manifest Anxiety Scale (RCMAS) and Child Behaviour Checklist (CBCL); Maternal depression was assessed by the Beck Depression Inventory-II (BDI-II)
    Results: 51 severe/moderate; 37 mild TBI subjects and 47 controls were recruited. There was no age difference between TBI and controls (mean 13.1 yrs; 13.2 yrs)(p=0.877). TBI children had significantly higher scores on BDS and CBCL than controls at 1 (p=0.003; p=0.015) and 6 months (p=0.04; p<0.001). 16/55 TBI children who completed the IES scored >17 at 1 month indicating acute stress disorder; at 6 months 14/47 scored >17 indicating post-traumatic stress disorder. There was no difference between TBI and controls on RCMAS at 1 or 6 months (p=0.92; p=0.83) There was a significant relationship between injury severity and 1 month BDS (p=0.001), 1 month CBCL (p=0.03) and 6 month CBCL (p<0.001) but no correlation between injury severity and 1 month IES (P=0.77), 6 month BDS (p=0.25) and 6 month IES (p=0.81). There was a significant correlation between BDI and 1 month BDS (p=0.002), 1 month CBCL (p<0.001) and 6 month CBCL p<0.001) but no correlation between BDI and 6 month BDS (p=0.38) or 6 month IES (p=0.39). There was significant correlation between IES and CBCL externalizing score at 6 months (p=0.005).
    Conclusion: TBI produces adverse psychological sequelae which persist for at least six months indicting the need for appropriate screening, follow-up and support.

    Conference Organiser - ICMS Pty Ltd