Adolescent psychiatric symptoms following preschool childhood mild traumatic brain injury: evidence from a birth cohort.

OBJECTIVE

To determine whether childhood mild traumatic brain injury (MTBI) is associated with behavioral problems in adolescence.

PARTICIPANTS

Children from a longitudinal birth cohort (initial N = 1265) were assigned to 1 of 3 groups: (1) inpatient group (n = 19) comprised children admitted to hospital for MTBI before age 5 years; (2) outpatient group (n = 57), children with any incidence of MTBI before age 5 seen by a general practitioner or at an accident and emergency department and sent home; (3) reference control group (n = 839).

OUTCOME MEASURES: Maternal and self-report regarding attention deficit/hyperactivity disorder, conduct disorder, anxiety disorder, mood disorder, and alcohol or illicit substance abuse/dependence obtained using Diagnostic and Statistical Manual of Mental Disorders (Third Edition Revised) criteria.

RESULTS

At age 14 to 16 years, children who had been hospitalized for MTBI during preschool years were significantly more likely to show symptoms of attention deficit/hyperactivity disorder (odds ratio = 4.2), conduct disorder/oppositional defiant disorder (odds ratio = 6.2), substance abuse (odds ratio = 3.6), and mood disorder (odds ratio = 3.1) but not anxiety disorder.

CONCLUSIONS

Preschool MTBI is associated with persistent negative effects on psychosocial development. These continuing problems are consistent with the view that preschool years represent a period of particular vulnerability following MTBI.