History of Somatization Is Associated with Prolonged Recovery from Concussion

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• 作者：Jeremy M. Root ; MD¹ ; ^{jroot@childrensnational.org" class="auth_mail" title="E-mail the corresponding author} ; Noel S. Zuckerbraun ; MD² ; Li Wang ; MS³ ; Daniel G. Winger ; MS³ ; David Brent ; MD⁴ ; Anthony Kontos ; PhD⁵ ; Robert W. Hickey ; MD²
• 关键词：prolonged concussion syndrome ; somatization ; gender differences
• 刊名：The Journal of Pediatrics
• 出版年：2016
• 出版时间：July 2016
• 年：2016
• 卷：174
• 期：Complete
• 页码：39-44.e1
• 全文大小：324 K

文摘

To determine the association between a history of somatization and prolonged concussion symptoms, including sex differences in recovery.

Study design

A prospective cohort study of 10- to 18-year-olds with an acute concussion was conducted from July 2014 to April 2015 at a tertiary care pediatric emergency department. One hundred twenty subjects completed the validated Children's Somatization Inventory (CSI) for pre-injury somatization assessment and Postconcussion Symptoms Scale (PCSS) at diagnosis. PCSS was re-assessed by phone at 2 and 4 weeks. CSI was assessed in quartiles with a generalized estimating equation model to determine relationship of CSI to PCSS over time.

Results

The median age of our study participants was 13.8 years (IQR 11.5, 15.8), 60% male, with separate analyses for each sex. Our model showed a positive interaction between total CSI score, PCSS and time from concussion for females P < .01, and a statistical trend for males, P = .058. Females in the highest quartile of somatization had higher PCSS than the other 3 CSI quartiles at each time point (B −26.7 to −41.1, P values <.015).

Conclusions

Patients with higher pre-injury somatization had higher concussion symptom scores over time. Females in the highest somatization quartile had prolonged concussion recovery with persistently high symptom scores at 4 weeks. Somatization may contribute to sex differences in recovery, and assessment at the time of concussion may help guide management and target therapy.