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 “The study suggests that brain injury is in some way related to
longer-term anxiety symptoms, while previously it was thought that
brain injury only leads to short-term effects,” said lead author
Michelle Albicini in an email.
The anxiety may have many causes, including actual brain damage or
the experience of living in an anxious family environment after the
injury, said Albicini, a researcher at Monash University School of
Psychological Sciences in Melbourne, Australia.
Albicini’s team reports in the Journal of Head Trauma Rehabilitation
that children with moderately severe brain injuries and females in
general were at the greatest risk for long-term psychological
effects compared with boys and children who had milder brain
injuries.
Traumatic brain injury (TBI) occurs when an outside force, usually a
blow to the head, causes some kind of brain dysfunction, such as
loss of consciousness, amnesia or damage to brain tissue that’s
visible on a scan.
But more research is needed to fully understand the long-term
psychological effects faced by people who experience TBIs during
childhood, the researchers write.
To explore the question they recruited young adults who had been
treated at a New Zealand hospital for a traumatic brain injury five
or more years earlier, when they were younger than 18 years old. For
comparison, the researchers also recruited a similar group of young
adults who were treated for childhood orthopedic injuries like
broken arms or legs but had no history of brain injury.
Among the participants with childhood brain injury, 65 had mild
injuries involving loss of consciousness for less than 20 minutes,
little or no amnesia, a hospital stay of less than 48 hours and
normal brain scans. Another 61 participants had moderate to severe
brain injuries involving longer hospital stays, more severe or
longer lasting symptoms and skull fractures or other physical
evidence of brain injury that could be seen on a scan.
The average age at injury for those with mild TBI and those with
orthopedic injuries was around 10-11 years old, while the
participants with more severe TBIs were younger, around 7 years old
on average, when they were injured. For most in the study group, it
had been at least 10 years since their injury and for some, 15 or
more years had passed.
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Each person met with a psychologist for diagnostic interviews to
screen for various psychological disorders including generalized
anxiety disorder, panic attacks, phobias and depression.
This revealed that compared to people with no brain injuries, those
with any type of TBI were five times more likely to have an anxiety
disorder.
People with past brain injuries were also about four times more
likely to suffer from panic attacks, specific phobias and
depression.
Those with moderate-severe brain injuries had the highest overall
rates of anxiety disorders and were most likely to suffer from
multiple anxiety disorders at once.
However, women were four times more likely than men to have an
anxiety disorder, regardless of whether they had a brain injury, the
authors note.
“These results emphasize the need to monitor children and
adolescents for the development of anxiety disorders after they have
a TBI,” said Dr. Jeffrey Max, a psychiatry professor at the
University of California, San Diego, who wasn’t involved in the
study.
It is important to keep in mind, however, that the research did not
look at the patients’ anxiety before their injury, making it
difficult to determine if the anxiety was a complication of the
injury, Max said.
“If TBI really causes an increased risk for anxiety disorder then
research on this topic could help us understand the brain mechanisms
and psychological mechanisms behind the development of anxiety
disorders,” Max said.
“While in most cases people recover 100 percent from brain injury, a
select few may go on to experience anxiety, depression, or other
ongoing psychological effects," Albicini said. “More work needs to
be done to help identify the risk factors for those people, and then
how we can help them, to lessen the burden of brain injury,”
SOURCE: bit.ly/2qOpoep Journal of Head Trauma Rehabilitation, online
May 17, 2017.
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