Alert on Link Between Concussions and Child/Youth Mental Health

(HealthDay News)

"This study shows that concussions can be much more than a physical head injury.There can be long-term emotional and cognitive impacts on a child's life that we have to be mindful of and help address."

"During concussion followup visits, it's extremely important for physicians to screen for mental health issues and factors that might predispose children to a mental health problem."

"I don't want parents to be scared of sending their children to sports based on this study."

"I think, regardless of a concussion, we should be on the lookout for mental health issues and be open to communicating about our own mental health. "There is such a large stigma around mental health, we are not always willing to talk about it."

Andree-Anne Ledoux, professor, Brain and Mind Research Institute, University of Ottawa Faculty of Medicine

For this study, researchers looked at cases relating to 152,482 children and youth in Ontario who had suffered concussions, along with 296,482 children in the province and youth with orthopedic injuries. Excluded for this study was anyone who required mental health investigation in the year prior to their injury. Mental health conditions were found to include anxiety and neurotic disorders, mood and eating disorders, schizophrenia, substance use disorder, suicidal ideation and disorders of psychological development.

These conditions were found to be more common within the group that had suffered concussions, than within the orthopedic group. Physicians and parents, stressed Dr.Ledoux, should ideally be aware of this linked heightened risk and have conversations with children about the state of their mental health. At the same time, she felt the importance of a message that not all patients who experience concussions will go on to develop mental health issues.

The study, led by the research group at the Children's Hospital of Eastern Ontario Research Institute, and headed by Dr.Ledoux, was published in the journal JAMA Network Open. Its conclusions are considered significant due in part to its size, along with the period of time covered. The study was geared to compare children and youth between the ages of five and 18 diagnosed with concussions, as opposed to those who were diagnosed with orthopedic injuries; as example, broken bones.

The ten-year period involved and the number of individual subjects in conjunction, enabled the conclusion that children and youth with concussions were 40 percent likelier to incur mental health issues, hospitalization and self-harm after the concussion, in comparison to those study subjects who had been the recipient of orthopedic injuries.

The connection between concussion and mental health is not new, having been connected and debated previously. Dr.Ledoux theorized a number of scenarios that have the potential to impact children and youth, bringing them to heightened risk of mental issues following a concussion. Concussions "trigger a cascade of biological and chemical mechanisms in your brain", resulting in a range of symptoms. On the other hand, mental health issues could arise in children with a predisposition and with poor coping skills.

As well, a paucity of normal activity and socializing in the wake of having a concussion could as also affect the mental health of patients. And nor could pain and sleep issues be negated as a possible cause; both often associated with concussion, could as well lead to issues with mental health. Screening for possible mental health impacts following concussion should become an integral part of the focus on preventing and diagnosing concussions.