Pediatric traumatic brain injury (TBI) is a public health concern, accounting for an estimated 600,000 emergency room visits each year in the United States. Young children, particularly those aged four and younger, have the highest rate of TBI-related emergency room visits than any other age group. Psychiatric symptoms, including anxiety and mood disorders, have been associated with childhood TBI, and may also contribute to co-occurring conditions such as cognitive impairment, chronic pain, and sleep disorders.
Previous research has indicated an association between pediatric TBI and short-term mood disorders, but little is known about the trajectory of psychiatric effects in pediatric TBI into adulthood. To address this gap, a team of researchers designed a study that evaluated the long-term prevalence of anxiety and mood disorders in patients with pediatric TBI injuries occurring before age 10. This study included 5,518 individuals who sustained a childhood TBI before 10 years of age, and classified individuals by psychiatric diagnoses that occurred up to age 25, including depression, anxiety, bipolar disorder, suicidal ideation, and self-injurious behavior. The results of the study showed that:
- Children who sustained a childhood TBI at an older age were more likely to develop both anxiety and mood disorders.
- Children who sustained both a childhood TBI and non-heard injury, such as orthopedic trauma, were significantly more likely to develop anxiety disorder later in life.
The researchers suggested that certain childhood ages may be more vulnerable after TBI, which may depend on stages of brain development. Different stages of brain development may be associated with different interactions between cognitive and emotional abilities and subsequently contribute to psychiatric consequences if disrupted by a TBI. These findings may indicate the existence of a critical period in brain development during which TBI is most detrimental. Early screening for risk factors in children who sustain a TBI, including age and other injuries, can result in earlier intervention for psychiatric disorders in high-risk groups.
Esterov D, Witkowski J, McCall D, et al. Risk factors for development of long-term mood and anxiety disorder after pediatric traumatic brain injury: a population-based, birth cohort analysis. Brain Injury. (April 2022).