By Thomas R. Collins
MIAMI, Florida — April 13, 2015 — Concussion predicts the development of both post-traumatic stress disorder and attention deficit hyperactivity disorder, researchers reported at the 35th Annual Meeting of the Anxiety and Depression Association of America (ADAA).
While the effects of concussions have been generating more attention in recent years, long-term psychiatric consequences are often overlooked, explained researchers from the University of Toronto, Toronto, Ontario, Canada, at a poster presentation here on April 10. Changes in mood and function are simply seen as a post-concussion syndrome.
Led by Melissa Furtado, BS, in conjunction with Martin Katzman, MD, University of Toronto, researchers involved 610 patients referred to the START (Stress, Trauma, Anxiety, Rehabilitation, Treatment) Clinic for Mood and Anxiety Disorders at the University of Toronto. As part of the intake process, these patients completed a Medical Intake Questionnaire, through which head injuries that resulted in a loss of consciousness or caused lingering symptoms were examined.
A consensus between the MINI International Neuropsychiatric Interview Plus 5.0.0 (MINI Plus) and the treating physician confirmed the psychiatric diagnoses during the intake assessment. The researchers then conducted analysis of variance and t-tests to examine the association between a previous concussion and the psychiatric diagnoses.
Their analyses demonstrated that concussions acted as a significant predictor for post-traumatic stress disorder (PTSD) (P = .002) and for attention-deficit hyperactivity disorder (ADHD) (P = .008), as well as for co-morbid PTSD and ADHD (P = .006).
The investigators also found that 28.6% of patients diagnosed with PTSD had suffered a concussion before their diagnosis, and 22.7% of those with ADHD had suffered a concussion. Additionally, 38.9% of those with co-morbid PTSD and ADHD had suffered a concussion.
A link between concussions and depression did not approach significance, even though such a link was expected. “Depression wasn’t anywhere near significant, which I know is a huge focus with concussions and depression and suicidality,” noted Furtado. “We hypothesise that what is treated as depression is actually undetected ADHD in these patients. So people are diagnosed with depression and are getting treatment for it, but then are diagnosed as treatment-resistant, when it may, in fact, be undetected ADHD.”
Furtado added that impulsivity in patients with ADHD may lead them to situations where they are prone to have concussion injuries.
[Presentation title: Concussions as a Predictor of Posttraumatic Stress Disorder and Attention Deficit Hyperactivity Disorder. Abstract 59]