Even Minor Brain Injuries Can Lead To Mental Health Issues, A New Study Shows

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While this past weekend’s Super Bowl had many fans’ eyes glued to the T.V., it also served as a reminder of the sport's controversial history with concussions and brain damage in its players. Activities like cycling, football, baseball, and basketball are consistently among the highest contributors of head injuries treated in U.S. hospital emergency rooms, according to the American Association of Neurological Surgeons. In a new study, patients with minor traumatic brain injuries had a higher likelihood of experiencing mental health problems than patients with injuries that didn’t involve the head, exhibiting symptoms of PTSD and/or depression both three and six months post-injury.

The CDC defines a traumatic brain injury as “a disruption in the normal function of the brain that can be caused by a bump, blow, or jolt to the head, or penetrating head injury.” They can range in severity from mild (“a brief change in mental status or consciousness”) to severe (“an extended period of unconsciousness or amnesia after the injury”). The new study, published in JAMA Psychiatry, assessed 1,155 patients with mild traumatic brain injuries, like a mild concussion, and 230 patients who had orthopedic injuries that didn’t involve the head. All patients were 17 years old and older and came from across 11 U.S. hospitals. The researchers evaluated participants for symptoms of post traumatic stress disorder (PTSD) and major depressive disorder (depression) three, six, and 12 months post-injury.

The results found that approximately one in five people with a mild traumatic brain injury may experience mental health symptoms up to six months after injury. The prevalence of PTSD and depression in the brain injury group versus the orthopedic trauma group did vary three months post-injury (20 percent versus roughly 9 percent) and six months post-injury (roughly 21 percent to around 12 percent). For the minor traumatic brain injury group, risk factors for developing PTSD six months post-injury included race, psychiatric history, education levels, and having an injury that resulted from assault or other violence. These risk factors were similar for major depressive disorder in the brain injury group, though cause of injury (violent or not) notably wasn’t a factor.

"Contrary to common assumptions, mild head injuries can cause long-term effects. These findings suggest that follow-up care after head injury, even for mild cases, is crucial, especially for patients showing risk factors for PTSD or depression," said Dr. Murray B. Stein, one of the study authors, in a statement.

The study further established the link between individuals with brain injuries and the risks these injuries, however minor, may pose for their mental health. Individual risk factors like education, race, history of mental health problems, and cause of injury were also identified, significantly increasing a person with minor traumatic brain injury’s risk for developing PTSD and depression.

"Mental health disorders after concussion have been studied primarily in military populations, and not much is known about these outcomes in civilians," said Patrick Bellgowan, Ph.D., program director of the National Institute of Neurological Disorders and Stroke, in the statement. "These results may help guide follow-up care and suggest that doctors may need to pay particular attention to the mental state of patients many months after injury."