@article{ref1,
title="Psychological factors associated with delayed symptom resolution in children with concussion",
journal="Journal of pediatrics",
year="2016",
author="Grubenhoff, Joseph A. and Currie, Dustin and Comstock, R. Dawn and Juarez-Colunga, Elizabeth and Bajaj, Lalit and Kirkwood, Michael W.",
volume="174",
number="",
pages="27-32.e1",
abstract="OBJECTIVE: To characterize the psychological factors associated with persistent symptoms after pediatric concussion. STUDY DESIGN: Longitudinal cohort study of 179 children with concussion 8-18 years old evaluated in a pediatric emergency department. Participants were followed for 1 month for delayed symptom resolution, defined as ≥3 symptoms that were new/worse than preinjury symptoms measured by the use of graded symptom inventory. Preinjury psychological traits were measured by parental report on subscales of the Personality Inventory for Children-2 (maladjustment, cognitive abilities, somatization). Child report of postinjury anxiety and injury perception were measured with the State-Trait Anxiety Inventory for Children and Children's Illness Perception Questionnaire. Psychological instrument scores were compared between those with and without delayed symptom resolution via a Kruskal-Wallis test. Associations between psychological traits and delayed symptom resolution were investigated by the use of logistic regression. <br><br>RESULTS: Delayed symptom resolution occurred in 21% of participants. Score distributions were significantly worse on the State-Trait Anxiety Inventory for Children (38 [IQR 33-40] vs 35 [IQR 31-39]; P = .04) and somatization subscale (1 [IQR 0-3] vs 1 [IQR 0-1]; P = .01) among children with delayed symptom resolution compared with children with early symptom resolution. Somatization was associated with delayed symptom resolution (aOR 1.35, 95% CI 1.08-1.69). The proportion of children with abnormal somatization scores was significantly greater in the delayed symptom resolution group (34.2%) than the early symptom resolution group (12.8%; P < .01). Other psychological measures were not different between groups. <br><br>CONCLUSION: Somatization is associated with delayed symptom resolution in this cohort of children with concussion. Postconcussive symptoms lasting at least 1 month may warrant referral to a neuropsychologist familiar with postconcussion care.<br><br>Copyright © 2016 Elsevier Inc. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="0022-3476",
doi="10.1016/j.jpeds.2016.03.027",
url="http://dx.doi.org/10.1016/j.jpeds.2016.03.027"
}