Long-Term Risk for Mood and Anxiety Disorders After Pediatric Traumatic Brain Injury: A Population-Based, Birth Cohort Analysis.
Dmitry Esterov, Julie Witkowski, Dana M McCall and 2 others
PMID 36731039WHAT IT FOUND
After predominantly mild or concussive head injury before age 10, children did not show a higher risk of diagnosed mood or anxiety disorders by age 25 than matched peers.
The overall result did not support the female mood finding.
Key findings
01In the primary adjusted analyses, TBI was not significantly associated with later mood disorder or anxiety disorder.
02Females with childhood TBI had a significantly increased adjusted risk of mood disorder, but the sex difference test was not significant.
03Analyses by injury severity and excluding Definite TBI did not show significant associations.
STILL TO COME
How it was doneWhat they found
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What it does not show
Most injuries were mild or concussive: 414 had Possible TBI and 140 had Probable TBI, with only 8 Definite TBI, so the study cannot answer what happens after moderate to severe injury. Psychiatric diagnoses came from medical records and manual review, not direct clinical assessment, so some cases may have been missed or misclassified. The cohort was from one county that was 96% White and primarily middle class, so results may not apply to more diverse populations. Only 5 TBI cases and 8 referents had bipolar disorder, so it was combined with depression into a broader mood disorder category. TBI after 10 years of age and repeat injuries were not assessed, so later head injuries could have affected the outcomes. The significant female mood finding was a secondary analysis, and the formal test for a sex difference was not significant.
Declared interests
The authors declared no conflicts of interest; the article is tagged as NIH extramural research support.
The easy way to misread this
Do not treat the female mood finding as proof that girls after mild TBI are at higher risk. The main mood and anxiety results were not significant, and the test for sex differences was not significant.