History of Functional Somatic Syndromes and Persistent Symptoms After Mild Traumatic Brain Injury

Katherine Green; Molly Cairncross; William J Panenka; Jacob L Stubbs; Noah D Silverberg

doi:10.1176/appi.neuropsych.20060159

History of Functional Somatic Syndromes and Persistent Symptoms After Mild Traumatic Brain Injury

J Neuropsychiatry Clin Neurosci. 2021 Spring;33(2):109-115. doi: 10.1176/appi.neuropsych.20060159. Epub 2020 Nov 18.

Authors

Katherine Green¹, Molly Cairncross¹, William J Panenka¹, Jacob L Stubbs¹, Noah D Silverberg¹

Affiliation

¹ Department of Psychiatry (Green, Panenka, Stubbs), and Department of Psychology (Silverberg), University of British Columbia, Vancouver, Canada; British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, Canada (Panenka, Stubbs); British Columbia Neuropsychiatry Program, University of British Columbia, Vancouver, Canada (Panenka); Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, Canada (Cairncross, Silverberg); and Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Vancouver, Canada (Cairncross, Silverberg).

PMID: 33203306
DOI: 10.1176/appi.neuropsych.20060159

Abstract

Objective: Somatization is thought to underlie functional somatic syndromes (FSSs) and may also contribute to prolonged symptoms after mild traumatic brain injury (mTBI). The investigators evaluated the prevalence of FSSs in patients seeking specialty care after mTBI and whether a history of FSSs was associated with symptom persistence.

Methods: A total of 142 patients with mTBI completed questionnaires regarding demographic information, injury characteristics, and medical history, including history of diagnosed FSSs at clinic intake (mean=41 days postinjury [SD=22.41]). Postconcussion symptoms were assessed at clinic intake and again 1 and 3 months later. A linear mixed-effects model was used to determine whether history of FSSs was related to persistent mTBI symptoms over time.

Results: A history of at least one FSS was reported by 20.4% of patients. In the linear mixed model, postconcussion symptom scores were not significantly different over time among patients with a history of one or more FSSs or two or more FSSs from those with no FSSs. A history of one or more FSSs or two or more FSSs (versus no FSS) was not associated with increased odds of severe postconcussion symptoms at clinic intake (one or more FSSs: odds ratio=0.88, 95% CI=0.38-2.03; two or more FSSs: odds ratio=1.78, 95% CI=0.45-7.03), at the 1-month follow-up visit (one or more FSSs: odds ratio=0.57, 95% CI=0.22-1.45; two or more FSSs: odds ratio=0.57, 95% CI=0.14-2.37), or at the 3-month follow-up visit (one or more FSSs: odds ratio=0.97, 95% CI=0.36-2.63; two or more FSSs: odds ratio=1.27, 95% CI=0.29-5.65).

Conclusions: In this sample, the prevalence rates of FSSs were higher than rates previously reported for the general population. However, FSS history did not predict higher postconcussion symptom burden at clinic intake or persistence over the following 3 months. Further research is needed to clarify the potential role of somatization in poor mTBI outcome.

Keywords: Functional Somatic Syndromes,; Mild Traumatic Brain Injury; Postconcussion Symptoms; Somatoform Disorders.

MeSH terms

Adult
Brain Concussion / complications*
Female
Humans
Male
Post-Concussion Syndrome / epidemiology*
Prevalence
Somatoform Disorders / epidemiology*
Surveys and Questionnaires