2025/05/19 by Noah D. Silverberg, Mathilde Rioux, Ana Mikolić +3 · 1 voice
Medicine · #Psychosomatic Disorders and Their Treatments #Traumatic Brain Injury Research #Traumatic Brain Injury and Neurovascular Disturbances
paper · doi:10.1097/htr.0000000000001068
openalex publication_date 2025/05/19 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/30
OBJECTIVE: Mild traumatic brain injury (mTBI) may be a common precipitant of Somatic Symptom Disorder (SSD). This study examined the prevalence, correlates, predictors, and functional impact of SSD after mTBI. SETTING: Follow up of patients recruited from emergency departments and urgent care centers. PARTICIPANTS: Adults with mTBI (N = 476). DESIGN: Secondary analysis of a clinical trial (Clinicaltrials.gov NCT04704037). MAIN MEASURES: Early illness beliefs (Illness Perceptions Questionnaire-Revised; IPQ-R) were assessed ~2 weeks after mTBI and outcomes were assessed at 6 months post-injury, including SSD symptoms (Somatic Symptom Disorder-B Criteria Scale; SSD-12), post-concussion symptoms (Rivermead Post Concussion Symptoms Questionnaire; RPQ), disability (World Health Organization Disability Assessment Schedule; WHODAS), and psychiatric diagnoses (MINI Neuropsychiatric Inventory). SSD diagnosis was operationalized as having persistent symptoms and SSD-12 ≥ 16 (≥23 in sensitivity analyses). RESULTS: 15-27% of the sample met criteria for SSD at 6 months post-injury. Participants with SSD reported more pain and post-concussion symptoms, and were more likely to have comorbid Major Depressive Disorder (OR = 9.1, 95% CI = 5.3, 16.2) and at least 1 anxiety disorder (OR = 5.6, 95% CI = 3.6-8.8) compared to those without SSD. Early illness beliefs, specifically that mTBI has serious life consequences (OR = 1.2, 95% CI = 1.1-1.3) and causes distress (OR = 1.1, 95% CI = 1.0-1.2), were associated with later SSD. SSD symptoms contributed to prediction of global functional disability (WHODAS) over and above post-concussion symptom severity (RPQ; ΔDeviance = 0.22, P < .001). CONCLUSIONS: SSD after mTBI is associated with an increased burden of symptoms, comorbidity, and disability. Early identification of at-risk patients appears feasible. SSD may be a useful framework for conceptualizing poor outcome from mTBI in patients with prominent psychological distress and guiding rehabilitation.