Children and teenagers who sustain a concussion are at increased risk of mental health issues, psychiatric hospitalization, and self-harm, suggests a study published in JAMA Network Open.

“During concussion follow-up visits, it’s extremely important for physicians to screen for mental health issues and factors that might predispose children to a mental health problem,” said study lead author Andrée-Anne Ledoux, PhD, of the Children’s Hospital of Eastern Ontario Research Institute Ottawa, Canada. “By intervening early and providing children and adolescents with the right tools to cope and adapt to the trauma and symptoms of a concussion, we can help them become more resilient and prevent the impacts of long-term mental health issues.”

The population-based cohort study compared 152,321 children and youths ages 5 through 18 who experienced a concussion with 296,482 children and youths who experienced an orthopedic injury between April 1, 2010, and March 31, 2020, in Ontario, Canada. Participants were matched 1:2 by age and sex and had no mental health visits the year before injury.

Related: ADHD Diagnoses More Common in Children With Severe Traumatic Brain Injury

Compared with children and teens with an orthopedic injury, those with concussion had a 40% increased risk of developing a mental health issue. Researchers reported adjusted hazard ratios of 1.39 for developing a mental health issue, 1.49 for self-harm, and 1.47 for psychiatric hospitalization after a concussion.

The investigation did not find a significantly higher risk of suicide after concussion, which researchers suspect is because of the low number of deaths by suicide in the study population. 

“Despite not being statistically significant,” they wrote, “it is clinically relevant that the concussion group had approximately twice the incidence rate of suicide; thus, health care practitioners should monitor suicidality and self-harm behaviors in children and youths after concussion.”

References

Ledoux AA, Webster RJ, Clarke AE, et al. Risk of mental health problems in children and youths following concussion. JAMA Netw Open. Published online March 7, 2022. doi: 10.1001/jamanetworkopen.2022.1235

Children and youth are at higher risk of developing mental health issues following a concussion. News release. University of Ottawa. March 9, 2022. Accessed March 17, 2022.