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Review
. 2023 Mar;23(3):49-58.
doi: 10.1007/s11910-023-01251-9. Epub 2023 Feb 10.

Management of Psychological Complications Following Mild Traumatic Brain Injury

Noah D Silverberg  1   2 , Ana Mikolić  3   4
Affiliations
Review

Management of Psychological Complications Following Mild Traumatic Brain Injury

Noah D Silverberg et al. Curr Neurol Neurosci Rep. 2023 Mar.

Abstract

Purpose of review: It has been clear for decades that psychological factors often contribute to mild traumatic brain injury (mTBI) outcome, but an emerging literature has begun to clarify which specific factors are important, when, for whom, and how they impact recovery. This review aims to summarize the contemporary evidence on psychological determinants of recovery from mTBI and its implications for clinical management.

Recent findings: Comorbid mental health disorders and specific illness beliefs and coping behaviors (e.g., fear avoidance) are associated with worse recovery from mTBI. Proactive assessment and intervention for psychological complications can improve clinical outcomes. Evidence-based treatments for primary mental health disorders are likely also effective for treating mental health disorders after mTBI, and can reduce overall post-concussion symptoms. Broad-spectrum cognitive-behavioral therapy may modestly improve post-concussion symptoms, but tailoring delivery to individual psychological risk factors and/or symptoms may improve its efficacy. Addressing psychological factors in treatments delivered primarily by non-psychologists is a promising and cost-effective approach for enhancing clinical management of mTBI. Recent literature emphasizes a bio-psycho-socio-ecological framework for understanding mTBI recovery and a precision rehabilitation approach to maximize recovery. Integrating psychological principles into rehabilitation and tailoring interventions to specific risk factors may improve clinical management of mTBI.

Keywords: Brain concussion; Mental health; Post-concussion symptoms; Precision medicine; Psychological factors; Treatment.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
    1. Matney C, et al. Understanding patients with traumatic brain injury. In: Traumatic Brain Injury: A Roadmap for Accelerating Progress. US: National Academies Press; 2022.
    1. Van Praag DLG, et al. Post-traumatic stress disorder after civilian traumatic brain injury: a systematic review and meta-analysis of prevalence rates. J Neurotrauma. 2019;36(23):3220–32. - PubMed - PMC - DOI
    1. Iljazi A, et al. Post-traumatic stress disorder after traumatic brain injury—a systematic review and meta-analysis. Neurol Sci. 2020;41(10):2737–46. - PubMed - DOI
    1. Stein MB, et al. Risk of posttraumatic stress disorder and major depression in civilian patients after mild traumatic brain injury: a TRACK-TBI study. JAMA Psychiat. 2019;76(3):249–58. - DOI
    1. van der Vlegel M, et al. The association of post-concussion and post-traumatic stress disorder symptoms with health-related quality of life, health care use and return-to-work after mild traumatic brain injury. J Clin Med. 2021;10(11):2473.

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