Risk factors for development of long-term mood and anxiety disorder after pediatric traumatic brain injury: a population-based, birth cohort analysis.
Dmitry Esterov, Julie Witkowski, Dana M McCall and 3 others
PMID 35604956WHAT IT FOUND
Children who sustained a traumatic brain injury at age 5 or older had a higher risk of developing anxiety or mood disorders by age 25 than those injured before age 5.
Injury severity and other factors showed weaker or inconsistent associations.
Key findings
01Older age at the time of initial TBI was significantly associated with an increased risk of subsequent anxiety and mood disorders after adjusting for non-TBI characteristics.
02The population attributable risk for anxiety was highest for older age at initial TBI (54.5% using an age cutoff of 5), followed by extracranial injury and definite TBI.
03Definite TBI and extracranial injury were associated with increased anxiety risk, but the number of definite TBI cases was very small (n=8), limiting certainty.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study included very few cases of definite (moderate-severe) TBI (only 8), making the findings regarding injury severity less reliable. The cohort was predominantly white and from a single geographic location (Olmsted County, Minnesota), which may limit generalizability to other racial, ethnic, or socioeconomic groups. Extracranial injury was recorded as a simple yes/no variable without detail on severity or type, limiting understanding of its specific impact. The study did not account for some potential confounders like early life stress or specific adverse childhood events. Mood disorders combined depression and bipolar disorder due to low numbers of bipolar cases, which may obscure distinct risk patterns.
Declared interests
Dr. Esterov received training or funding through the Center for Clinical and Translational Science. The publication was supported by a grant from the National Center for Advancing Translational Science (NCATS).
The easy way to misread this
Do not interpret the association between older age at injury and psychiatric risk as evidence that early childhood TBI (ages 0-4) is harmless. The study found lower relative risk in this group, but incidence of TBI is highest in children aged 0-4, meaning a large number of children in this age group still sustain injuries. Additionally, the finding that definite TBI increases anxiety risk is based on only 8 cases and should not be used to dismiss the importance of injury severity in other contexts.