Novel Psychiatric Disorders Following Mild Traumatic Brain Injury in the Second Year of the Adolescent Brain Cognitive Development Study

Abstract

Pediatric mild traumatic brain injury (mTBI) is common and can potentially lead to novel psychiatric disorders (NPDs). However, the psychiatric sequelae of mTBI in community-dwelling children require further study. NPDs were characterized during the first 2 years following injury in children with a first lifetime mTBI between 9 and 11 years of age in the Adolescent Brain Cognitive Development study (n = 99), compared with orthopedically injured (n = 380) and noninjured (n = 374) controls. Outcomes were defined as NPD-Any (NPD-A), which included all NPDs with onset during the study period, and NPD-Current (NPD-C), which included only those NPDs that were still active at the follow-up study visit. Possible confounders, including injury and non-injury-related factors, were also considered. NPDs were common at the year 2 study visit, particularly anxiety disorders, but rates were similar across injury groups. Mild TBI was not associated with differential odds of NPD. However, family psychiatric history predicted greater odds of NPD (for NPD-C, odds ratio [OR] = 1.345; 95% confidence interval [CI] = 1.124–1.615; p < 0.001; for NPD-A, OR = 1.217; 95% CI = 1.078–1.375; p = 0.002), and pre-injury psychiatric disorder was associated with increased risk of NPD at year 2 (for NPD-C, OR = 1.557; 95% CI = 1.022–2.346; p = 0.037; for NPD-A, OR = 1.568; 95% CI = 1.198–2.055, p = 0.001). In this representative community-dwelling sample of children in the United States who experienced a first lifetime mTBI between 9 and 11 years of age, mTBI was not associated with risk for NPDs in the first 2 years following injury. However, non-injury-related factors, including family psychiatric history and pre-injury psychiatric disorders, were associated with NPDs.