@article{ref1,
title="History of somatization is associated with prolonged recovery from concussion",
journal="Journal of pediatrics",
year="2016",
author="Root, Jeremy M. and Zuckerbraun, Noel S. and Wang, Li and Winger, Daniel G. and Brent, David A. and Kontos, Anthony and Hickey, Robert W.",
volume="174",
number="",
pages="39-44.e1",
abstract="OBJECTIVE: To determine the association between a history of somatization and prolonged concussion symptoms, including sex differences in recovery. STUDY DESIGN: A prospective cohort study of 10- to 18-year-olds with an acute concussion was conducted from July 2014 to April 2015 at a tertiary care pediatric emergency department. One hundred twenty subjects completed the validated Children's Somatization Inventory (CSI) for pre-injury somatization assessment and Postconcussion Symptoms Scale (PCSS) at diagnosis. PCSS was re-assessed by phone at 2 and 4 weeks. CSI was assessed in quartiles with a generalized estimating equation model to determine relationship of CSI to PCSS over time. <br><br>RESULTS: The median age of our study participants was 13.8 years (IQR 11.5, 15.8), 60% male, with separate analyses for each sex. Our model showed a positive interaction between total CSI score, PCSS and time from concussion for females P < .01, and a statistical trend for males, P = .058. Females in the highest quartile of somatization had higher PCSS than the other 3 CSI quartiles at each time point (B -26.7 to -41.1, P values <.015). <br><br>CONCLUSIONS: Patients with higher pre-injury somatization had higher concussion symptom scores over time. Females in the highest somatization quartile had prolonged concussion recovery with persistently high symptom scores at 4 weeks. Somatization may contribute to sex differences in recovery, and assessment at the time of concussion may help guide management and target therapy.<br><br>Copyright © 2016 Elsevier Inc. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="0022-3476",
doi="10.1016/j.jpeds.2016.03.020",
url="http://dx.doi.org/10.1016/j.jpeds.2016.03.020"
}