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The Link Between Childhood TBIs and Anxiety Disorders

New research out of Australia suggests that children who suffer a traumatic brain injury during childhood are more likely to develop psychological disorders like anxiety, depression and certain phobias.

“The study suggests that brain injury is in some way related to longer-term anxiety symptoms, while previously it was thought that brain injury only leads to short-term effects,” said lead author Michelle Albicini.

TBIs In Children

For their study, researchers recruited young adults who had been treated at a New Zealand hospital for a traumatic brain injury five or more years ago. All individuals had suffered the TBI when they were 17 years old or younger. Researchers also recruited a control group that was comprised of individuals who were treated for childhood orthopedic injuries like fractures and sprains, but had no history of TBI.

Of those individuals in the TBI group, 65 reported mild head injuries involving loss of consciousness for less than 20 minutes, little or no amnesia and a hospital stay of less than 48 hours. 61 others had more severe symptoms, including longer hospitals stays, lengthy symptoms and physical evidence of brain injury on a head scan. The average age for individuals who suffered a mild TBI was between 10 and 11 years old, while the average age for people who suffered a more severe TBI was around seven years old.

Each group was asked to meet with a psychologist to be screened for various psychological disorders including generalized anxiety disorder, phobias, panic attacks and depression.

Study Results

After comparing the findings between all three groups, researchers found that individuals who had suffered a brain injury during childhood were five times more likely to have an anxiety disorder compared to those who hadn’t suffered a childhood TBI. Here are some more findings from the study:

  • Individuals with past brain injuries were about four times more likely to suffer from panic attacks, depression and certain phobias than those without childhood brain injuries.
  • Participants with the most severe brain injuries had the highest overall rates of anxiety disorders, and they were more likely to suffer from multiple anxiety disorders at once.
  • Women were four times more likely to have an anxiety disorder than men, regardless of whether they had suffered a childhood TBI.

“These results emphasize the need to monitor children and adolescents for the development of anxiety disorders after they have a TBI,” said Dr. Jeffrey Max, a psychiatry professor at the University of California, San Diego, who wasn’t involved in the study. “If TBI really causes an increased risk for anxiety disorder then research on this topic could help us understand the brain mechanisms and psychological mechanisms behind the development of anxiety disorders.”

Researchers stopped short of saying that TBIs are causally related to psychological disorders, especially considering that they noted that levels of anxiety were not measured prior to injury, but it’s still food for thought. It speaks to the larger point that there still may be cognitive issues after a TBI even if there are no physical symptoms. Doctors need to be aware of this potential link between TBI and cognitive problems so that these issues can be treated before they grow into full-blown anxiety disorders. It may not be possible to return the brain to its pre-TBI state, but if we make psychological counseling and other resources available to at-risk children, maybe we can mitigate or eliminate these cognitive issues.

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David Chang, MD-PhD, DABNS, Roseville, MN
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