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The relationship of psychological and cognitive factors and opioids in the development of the postconcussion syndrome in general trauma patients with mild traumatic brain injury

Published online by Cambridge University Press:  25 October 2006

SUSANNE MEARES ,
E. ARTHUR SHORES ,
JENNIFER BATCHELOR ,
IAN J. BAGULEY ,
JENNIFER CHAPMAN ,
JOSEPH GURKA  and
JENO E. MAROSSZEKY
SUSANNE MEARES
Affiliation:
Department of Psychology, Macquarie University, New South Wales, Australia
E. ARTHUR SHORES
Affiliation:
Department of Psychology, Macquarie University, New South Wales, Australia
JENNIFER BATCHELOR
Affiliation:
Department of Psychology, Macquarie University, New South Wales, Australia
IAN J. BAGULEY
Affiliation:
Department of Rehabilitation Medicine, Westmead Hospital, New South Wales, Australia
JENNIFER CHAPMAN
Affiliation:
Department of Rehabilitation Medicine, Westmead Hospital, New South Wales, Australia
JOSEPH GURKA
Affiliation:
Department of Rehabilitation Medicine, Westmead Hospital, New South Wales, Australia
JENO E. MAROSSZEKY
Affiliation:
Department of Rehabilitation Medicine, Westmead Hospital, New South Wales, Australia
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Abstract

The relationship of psychological and cognitive factors in the development of the postconcussion syndrome (PCS) following mild uncomplicated traumatic brain injury (mTBI) has received little study. This may be because of the widely held belief that neurological factors are the cause of early PCS symptoms, whereas psychological factors are responsible for enduring symptoms. To further understand these relationships, the association between PCS and neuropsychological and psychological outcome was investigated in 122 general trauma patients, many of whom had orthopedic injuries, around 5 days following mTBI. Apart from verbal fluency, participants with a PCS did not differ in their performances on neuropsychological measures compared to those without a PCS. Individuals with a PCS reported significantly more psychological symptoms. Large effect sizes present on the psychological measures showed that the difference between participants with a PCS and without was greater on psychological than on neuropsychological measures. Analyses also revealed a relationship between opioid analgesia and depression, anxiety and stress, and opioids and reduced learning. The results suggest that psychological factors are present much earlier than has previously been considered in the development of the PCS. (JINS, 2006, 12, 792–801.)

Keywords

Brain concussionHead injuryMinorNeuropsychologicalAcute Stress DisorderNarcotic
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 12 , Issue 6 , November 2006 , pp. 792 - 801
Copyright
© 2006 The International Neuropsychological Society

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