title: 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.
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.
authors.affiliation: Department of Psychology, Macquarie University, New South Wales, Australia.
authors.forename: Susanne
authors.initials: S
authors.lastname: Meares
authors.forename: E Arthur
authors.initials: EA
authors.lastname: Shores
authors.forename: Jennifer
authors.initials: J
authors.lastname: Batchelor
authors.forename: Ian J
authors.initials: IJ
authors.lastname: Baguley
authors.forename: Jennifer
authors.initials: J
authors.lastname: Chapman
authors.forename: Joseph
authors.initials: J
authors.lastname: Gurka
authors.forename: Jeno E
authors.initials: JE
authors.lastname: Marosszeky
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000494:pharmacology / Q000627:therapeutic use*; D001930:Brain Injuries / Q000150:complications / Q000188:drug therapy / Q000523:psychology; D003071:Cognition / Q000187:drug effects* / Q000502:physiology; D003710:Demography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009294:Narcotics / Q000494:pharmacology / Q000627:therapeutic use*; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D010146:Pain / Q000188:drug therapy / Q000209:etiology; D038223:Post-Concussion Syndrome / Q000188:drug therapy / Q000209:etiology / Q000523:psychology; D012189:Retrospective Studies
chemical_list: D000701:Analgesics, Opioid; D009294:Narcotics