Citation

Tuborgh A, Svendsen SW, Elklit A, Hunter J, Ørnbøl E, Jensen JS, Schröder A, Nielsen JF, Næss-Schmidt ET, Thastum MM, Rask CU. J. Psychosom. Res. 2022; 164: e111100.

Copyright

(Copyright © 2022, Elsevier Publishing)

DOI

10.1016/j.jpsychores.2022.111100

PMID

36502555

Abstract

Concussion, the mildest form of traumatic brain injury (TBI), is typically conceptualized as an injury resulting in reversible, functional disturbance of the brain rather than structural injury [1]. The estimated incidence of hospital-treated concussion is 100-300/100,000 person-years [2,3] and highest in young age groups [[2], [3], [4]]. The true incidence may fall in the range of 300-750/100,000 person-years, as many cases are not examined in a hospital setting [5,6]. A considerable percentage of patients experience post-concussion symptoms (PCS) including a range of somatic, cognitive and emotional symptoms [[7], [8], [9]], which often remit spontaneously [10,11]. At least 5-15% develop long-lasting PCS (i.e., PCS lasting more than three months) [12], and the prevalence may reach 41% depending on study population, case definitions and measures used [8,13,14].

Long-lasting PCS are associated with prolonged or even permanent limitations in social and vocational functioning [15] and reduced health-related quality of life [16] and therefore require effective interventions [[17], [18], [19]]. The development of PCS can be understood according to a multifactorial disease model where negative illness perceptions and maladaptive illness behaviour early after concussion are associated with worse prognosis [20]. Cognitive behavioural therapy (CBT) targeting such factors in the form of symptom catastrophising and avoiding activities [21,22] have shown promising effects [[23], [24], [25]]. Using similar principles, we recently developed [26] and tested the early intervention "Get going After ConcussIoN" (GAIN) in a randomised controlled design [27] in adolescents and young adults with PCS 2-6 months after their injury. The control group received enhanced usual care (EUC) which consisted of psychoeducation about the multifactorial disease model for long-lasting PCS, including advice on adaptive illness behaviour, while the intervention group received GAIN, an individually tailored 8-week intervention + EUC (hereafter coined GAIN). GAIN demonstrated a larger reduction of PCS than EUC at 3-month follow-up...

Language: en

Keywords

Concussion; Mild traumatic brain injury; ECR-RS; Experiences in close relationships-relationship structure questionnaire; RPQ; The Rivermead post-concussion symptoms questionnaire