A recent study (from 9/13/16) on concussion in teens caught my attention this week. Sports related concussions in teens can lead to multiple symptoms including dizziness, headache, fatigue, poor sleep, poor concentration, and mood disturbances such as depression and anxiety. Though symptoms usually resolve within a few weeks, they may linger. For teens who continue to have post-concussive symptoms, the results can be debilitating. They may miss school, fall behind in their classes, become socially isolated (especially if unable to participate in their sports or activities of interest), and have symptoms of irritability, depression, and even thoughts of suicide. Treatment for teens who have prolonged symptoms can be a challenge.
The study published in Pediatrics, highlighted an innovative approach to the treatment of post-concussion symptoms. They randomized a sample of participants to receive treatment as usual (visits with their primary care provider, a sports or rehabilitation specialist, and possible physical therapist) or to receive an innovative collaborative care approach. The collaborative care team included behavioral therapy in the form of cognitive behavioral therapy, rehabilitation specialist, and possible medication management (to treat sleep disturbance or mood). The treatment lasted for 6 months. The findings were impressive. The teens who received the more holistic approach from the collaborative care model had improved quality of life, decreased symptoms of concussion, and decreased symptoms of depression.
While this study was relatively small (a total of 49 participants with 25 in the collaborative care group), it has potentially big implications for how we may treat prolonged concussion symptoms moving forward.
The lead author offers these ‘take home’ tips for parents and youth who may experience or have concussion:
- If concussion symptoms haven’t improved after a month, consider seeking additional help. You may want to work with a psychologist or therapist with expertise in cognitive behavioral therapy in addition to medical treatment.
- Ask your health care provider to screen for depression because concussion and depression tend to co-occur.
- Identify a point-person in the school (nurse, counselor, lead teacher) who can work with you to consider whether any modifications or accommodations can be helpful during the recovery period.