Journal of the International Neuropsychological Society



The relationship of psychological and cognitive factors and opioids in the development of the postconcussion syndrome in general trauma patients with mild traumatic brain injury


SUSANNE  MEARES  a1 , E. ARTHUR  SHORES  a1 c1 , JENNIFER  BATCHELOR  a1 , IAN J.  BAGULEY  a2 , JENNIFER  CHAPMAN  a2 , JOSEPH  GURKA  a2 and JENO E.  MAROSSZEKY  a2
a1 Department of Psychology, Macquarie University, New South Wales, Australia
a2 Department of Rehabilitation Medicine, Westmead Hospital, New South Wales, Australia

Article author query
meares s   [PubMed][Google Scholar] 
shores ea   [PubMed][Google Scholar] 
batchelor j   [PubMed][Google Scholar] 
baguley ij   [PubMed][Google Scholar] 
chapman j   [PubMed][Google Scholar] 
gurka j   [PubMed][Google Scholar] 
marosszeky je   [PubMed][Google Scholar] 

Abstract

The relationship of psychological and cognitive factors in the development of the postconcussion syndrome (PCS) following mild uncomplicated traumatic brain injury (mTBI) has received little study. This may be because of the widely held belief that neurological factors are the cause of early PCS symptoms, whereas psychological factors are responsible for enduring symptoms. To further understand these relationships, the association between PCS and neuropsychological and psychological outcome was investigated in 122 general trauma patients, many of whom had orthopedic injuries, around 5 days following mTBI. Apart from verbal fluency, participants with a PCS did not differ in their performances on neuropsychological measures compared to those without a PCS. Individuals with a PCS reported significantly more psychological symptoms. Large effect sizes present on the psychological measures showed that the difference between participants with a PCS and without was greater on psychological than on neuropsychological measures. Analyses also revealed a relationship between opioid analgesia and depression, anxiety and stress, and opioids and reduced learning. The results suggest that psychological factors are present much earlier than has previously been considered in the development of the PCS. (JINS, 2006, 12, 792–801.)

(Received January 31 2006)
(Revised July 7 2006)
(Accepted July 7 2006)


Key Words: Brain concussion; Head injury; Minor; Neuropsychological; Acute Stress Disorder; Narcotic.

Correspondence:
c1 Correspondence and reprint requests to: E. A. Shores, Department of Psychology, Macquarie University, North Ryde, New South Wales, 2109, Australia. E-mail: ashores@psy.mq.edu.au


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