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J Pediatr. 2016 Jul;174:39-44.e1. doi: 10.1016/j.jpeds.2016.03.020. Epub 2016 Apr 5.

History of Somatization Is Associated with Prolonged Recovery from Concussion.

Author information

1
Emergency Medicine and Trauma Services, Children's National Medical Center, Washington, DC. Electronic address: jroot@childrensnational.org.
2
Department of Pediatrics, Division of Pediatric Emergency Medicine, Children's Hospital of Pittsburgh, Pittsburgh, PA.
3
Office of Clinical Research, Health Sciences, University of Pittsburgh, Pittsburgh, PA.
4
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA.
5
Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA.

Abstract

OBJECTIVE:

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.

KEYWORDS:

gender differences; prolonged concussion syndrome; somatization

PMID:
27059916
PMCID:
PMC4925238
DOI:
10.1016/j.jpeds.2016.03.020
[Indexed for MEDLINE]
Free PMC Article

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