title: Randomised, waiting list controlled trial of cognitive-behavioural therapy for persistent postconcussional symptoms after predominantly mild-moderate traumatic brain injury.
abstract: BACKGROUND
  Persistent postconcussional symptoms (PCS) can be a source of distress and disability following traumatic brain injury (TBI). Such symptoms have been viewed as difficult to treat but may be amenable to psychological approaches such as cognitive-behavioural therapy (CBT).
  
  
  OBJECTIVE
  To evaluate the effectiveness of a 12-session individualised, formulation-based CBT programme.
  
  
  METHODS
  Two-centre randomised waiting list controlled trial with 46 adults with persistent PCS after predominantly mild-to-moderate TBI (52% with post-traumatic amnesia (PTA)≤24 hours), but including some with severe TBIs (20% with PTA>7 days).
  
  
  RESULTS
  Improvements associated with CBT were found on the primary outcome measures relating to quality of life (using the Quality of Life Assessment Schedule and the Brain Injury Community Rehabilitation Outcome Scale). Treatment effects after covarying for treatment duration were also found for PCS and several secondary outcomes, including measures of anxiety and fatigue (but not depression or post-traumatic stress disorder (PTSD)). Improvements were more apparent for those completing CBT sessions over a shorter period of time, but were unrelated to medicolegal status, injury severity or length of time since injury.
  
  
  CONCLUSIONS
  This study suggests that CBT can improve quality of life for adults with persistent PCS and potentially reduce symptoms for some, in the context of outpatient brain injury rehabilitation services.
  
  
  BACKGROUND
  ISRCTN49540320.
authors: Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, London, King's College, London, UK Lishman Unit, Maudsley Hospital, South London & Maudsley NHS Foundation Trust, London, UK.
authors: Sebastian D S
authors: http://orcid.org/0000-0002-2173-9870
authors: SD
authors: Potter
authors: Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, London, King's College, London, UK Lishman Unit, Maudsley Hospital, South London & Maudsley NHS Foundation Trust, London, UK.
authors: Richard G
authors: RG
authors: Brown
authors: Section of Cognitive Neuropsychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK Lishman Unit, Maudsley Hospital, South London & Maudsley NHS Foundation Trust, London, UK.
authors: Simon
authors: S
authors: Fleminger
mesh_terms: D000328:Adult; D001924:Brain Concussion / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D017063:Outcome Assessment, Health Care; D038223:Post-Concussion Syndrome / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors