title: The prospective course of postconcussion syndrome: the role of mild traumatic brain injury.
abstract: OBJECTIVE
  To investigate whether postconcussion syndrome (PCS) represents long-term sequelae associated with mild traumatic brain injury (mTBI).
  
  
  METHODS
  Prospective consecutive admissions to a Level 1 trauma hospital were assessed a mean 4.9 days and again 106.2 days post-injury. The final sample comprised 62 mTBI and 58 nonbrain injured trauma controls (TC). Change or lack of change in individual PCS-like symptoms and PCS was examined. Multilevel logistic regression was used to analyze whether mTBI predicts 3-month PCS (Time 2; T2); whether predictors of PCS (within 14 days of injury, Time 1; T1) predict 3-month PCS, and how change in these predictors from T1 to T2 were associated with change in PCS status. Variables included demographic, injury-related, financial incentives, neuropsychological, and psychiatric disorder.
  
  
  RESULTS
  MTBI did not predict PCS. PCS was comparable (T1: mTBI: 40.3%, TC: 50.0%; T2: mTBI: 46.8%, TC: 48.3%). At T2, 38.6% were new cases of PCS; between 30.8% and 86.2% reported either a new or more frequent symptom. A pre-injury depressive or anxiety disorder (OR = 2.99, 95% CI [1.38, 6.45]), and acute posttraumatic stress (OR = 1.05, 95% CI [1.00, 1.00]) were early markers of PCS, regardless of mTBI. An interaction between time and posttraumatic stress disorder (PTSD) suggested the relationship between the severity of PTSD symptoms and PCS strengthened over time (OR = 2.66, 95% CI [1.08, 6.55]). Pain was related to PCS. Females were more likely than males to have PCS.
  
  
  CONCLUSIONS
  The data suggest the phenomenon of PCS in trauma patients does not show an association with mTBI.
authors.affiliation: Department of Psychology, Macquarie University, Sydney, Australia.
authors.forename: Susanne
authors.initials: S
authors.lastname: Meares
authors.forename: E Arthur
authors.initials: EA
authors.lastname: Shores
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Taylor
authors.forename: Jennifer
authors.initials: J
authors.lastname: Batchelor
authors.forename: Richard A
authors.initials: RA
authors.lastname: Bryant
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: D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use; D001930:Brain Injuries / Q000150:complications* / Q000188:drug therapy; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000209:etiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D038223:Post-Concussion Syndrome / Q000145:classification / Q000150:complications* / Q000188:drug therapy; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011581:Psychological Tests; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid