title: Neuropsychiatric aspects of concussion.
abstract: Over the past decade, concussion has become the most widely discussed injury in contact sports. However, concussions also occur in several other settings, such as non-contact sports, elderly individuals, young children, military personnel, and victims of domestic violence. Concussion is frequently undiagnosed as a cause of psychiatric morbidity, especially when the patient has no history of loss of consciousness or direct head trauma. Almost all of the extant literature focuses on traumatic brain injury and assumes that concussion is merely a mild form of traumatic brain injury, which has resulted in a lack of understanding about what concussion is, and how to diagnose, monitor, and treat its varied neuropsychiatric symptoms. In this Review, we address key issues so that the psychiatric clinician can better understand and treat patients with a clinical phenotype that might be the direct result of, or be exacerbated by, concussion. Future research needs to focus on prospective clinical trials in all affected patient populations (ie, those affected by concussion and those affected by various degrees of traumatic brain injury), the identification of reliable biomarkers that can be used to assist with diagnosis and treatment response, and the development of effective treatment interventions. Clearly differentiating concussion from traumatic brain injury is essential to achieve reliable and clinically relevant outcomes.
authors.affiliation: Yale University School of Medicine, New Haven, CT, USA; Psychopharmacology Committee, Group for Advancement of Psychiatry, Dallas, TX, USA.
authors.forename: Rajiv
authors.initials: R
authors.lastname: Radhakrishnan
authors.affiliation: Yale University School of Medicine, New Haven, CT, USA; Silver Hill Hospital, New Canaan, CT, USA; Icahn School of Medicine at Mount Sinai, New York, NY, USA; Psychopharmacology Committee, Group for Advancement of Psychiatry, Dallas, TX, USA.
authors.forename: Amir
authors.initials: A
authors.lastname: Garakani
authors.affiliation: University of Southern California, Los Angeles, CA, USA; Psychopharmacology Committee, Group for Advancement of Psychiatry, Dallas, TX, USA.
authors.forename: Lawrence S
authors.initials: LS
authors.lastname: Gross
authors.affiliation: University of Southern California, Los Angeles, CA, USA; Psychopharmacology Committee, Group for Advancement of Psychiatry, Dallas, TX, USA.
authors.forename: Marcia K
authors.initials: MK
authors.lastname: Goin
authors.affiliation: University of Southern California, Los Angeles, CA, USA; Psychopharmacology Committee, Group for Advancement of Psychiatry, Dallas, TX, USA.
authors.forename: Janet
authors.initials: J
authors.lastname: Pine
authors.affiliation: New York University, New York, NY, USA; Psychopharmacology Committee, Group for Advancement of Psychiatry, Dallas, TX, USA.
authors.forename: Andrew E
authors.initials: AE
authors.lastname: Slaby
authors.affiliation: Pearson North America, Boston, MA, USA; Psychopharmacology Committee, Group for Advancement of Psychiatry, Dallas, TX, USA.
authors.forename: Calvin R
authors.initials: CR
authors.lastname: Sumner
authors.affiliation: University of Southern California, Los Angeles, CA, USA; Psychopharmacology Committee, Group for Advancement of Psychiatry, Dallas, TX, USA. Electronic address: dave.baron@usc.edu.
authors.forename: David A
authors.initials: DA
authors.lastname: Baron
mesh_terms: D001924:Brain Concussion / Q000175:diagnosis* / Q000523:psychology* / Q000628:therapy; D000070642:Brain Injuries, Traumatic / Q000175:diagnosis; D003937:Diagnosis, Differential; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome