title: Predictors of postconcussive symptoms 3 months after mild traumatic brain injury.
abstract: OBJECTIVE
  There is continuing controversy regarding predictors of poor outcome following mild traumatic brain injury (mTBI). This study aimed to prospectively examine the influence of preinjury factors, injury-related factors, and postinjury factors on outcome following mTBI.
  
  
  METHODS
  Participants were 123 patients with mTBI and 100 trauma patient controls recruited and assessed in the emergency department and followed up 1 week and 3 months postinjury. Outcome was measured in terms of reported postconcussional symptoms. Measures included the ImPACT Post-Concussional Symptom Scale and cognitive concussion battery, including Attention, Verbal and Visual memory, Processing Speed and Reaction Time modules, pre- and postinjury SF-36 and MINI Psychiatric status ratings, VAS Pain Inventory, Hospital Anxiety and Depression Scale, PTSD Checklist-Specific, and Revised Social Readjustment Scale.
  
  
  RESULTS
  Presence of mTBI predicted postconcussional symptoms 1 week postinjury, along with being female and premorbid psychiatric history, with elevated HADS anxiety a concurrent indicator. However, at 3 months, preinjury physical or psychiatric problems but not mTBI most strongly predicted continuing symptoms, with concurrent indicators including HADS anxiety, PTSD symptoms, other life stressors and pain. HADS anxiety and age predicted 3-month PCS in the mTBI group, whereas PTSD symptoms and other life stressors were most significant for the controls. Cognitive measures were not predictive of PCS at 1 week or 3 months.
  
  
  CONCLUSIONS
  Given the evident influence of both premorbid and concurrent psychiatric problems, especially anxiety, on postinjury symptoms, managing the anxiety response in vulnerable individuals with mTBI may be important to minimize ongoing sequelae.
authors.affiliation: Monash University, Melbourne, Australia. jennie.ponsford@monash.edu
authors.forename: Jennie
authors.initials: J
authors.lastname: Ponsford
authors.forename: Peter
authors.initials: P
authors.lastname: Cameron
authors.forename: Mark
authors.initials: M
authors.lastname: Fitzgerald
authors.forename: Michele
authors.initials: M
authors.lastname: Grant
authors.forename: Antonina
authors.initials: A
authors.lastname: Mikocka-Walus
authors.forename: Michael
authors.initials: M
authors.lastname: Schönberger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000175:diagnosis / Q000209:etiology; D001288:Attention / Q000502:physiology; D001930:Brain Injuries / Q000150:complications*; D003863:Depression / Q000175:diagnosis / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory / Q000502:physiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D010146:Pain / Q000175:diagnosis / Q000209:etiology; D010775:Photic Stimulation; D038223:Post-Concussion Syndrome / Q000175:diagnosis* / Q000209:etiology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011930:Reaction Time / Q000502:physiology; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D015599:Trauma Severity Indices; D014706:Verbal Learning / Q000502:physiology; D055815:Young Adult