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• W3099282688 abstract "Objective To compare the presentation of Post-Concussion Syndrome (PCS) based on whom the patient blames for the initial concussion. Background Psychological risk factors, such as pre-injury psychiatric disease and ongoing litigation, are associated with worsened PCS. We investigated whether blame attribution is another one of these psychological risk factors. Design/Methods 111 new patients presenting with PCS at a Canadian subspecialty concussion clinic were seen over 2 years. 91 patients (56 females, 35 males) were included. 20 patients were excluded for inability to define specific causative event (n = 13), underlying structural lesion (n = 1) or evidence of intracranial bleed (n = 6). Patients were separated into three groups: those attributing external blame (n = 70) those describing the incident as accidental (n = 20) and those attributing internal blame (n = 1). Patient observations included: subjective percentage of recovery (SPR), presence and severity of both headaches and psychiatric symptoms, and duration of symptoms at initial presentation. Psychiatric symptoms were graded 0–3 (0-absence, 1-mild, 2-moderate, 3-severe). Headache frequency was graded 0–4 (0-absence, 1-rare, 2-episodic, 3-chronic, 4-persistent). Results More patients belonged to the External group compared to Accidental or Internal groups ( p < 0.0001). Mean SPR in the Accidental group was 73% as compared to 44% in External ( p < 0.0001). Mean headache frequency was 1.7 for Accidental and 2.64 for External ( p = 0.001) Mean severity of psychiatric symptoms was 0.55 in Accidental and 2.24 in External ( p < 0.0001). 77% of patients in the External group were diagnosed with post-injury PTSD, with 0% diagnosed in the Accidental group ( p < 0.0001). Post-injury depression and anxiety each occurred 3 times more frequently in the External group compared to Accidental ( p < 0.0001). Mean symptom duration at initial presentation was 10.2 months in Accidental and 22.49 months in External ( p = 0.001). The External and Accidental groups did not differ significantly in age ( p = 0.938), number of concussions ( p = 0.72), gender ( p = 0.908), or preexisting psychiatric illness ( p = 0.735). Conclusions This study suggests blame attribution may be an important factor in determining patients at risk of a more severe and prolonged course of PCS." @default.
• W3099282688 created "2020-11-23" @default.
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• W3099282688 date "2020-11-16" @default.
• W3099282688 modified "2023-09-25" @default.
• W3099282688 title "The Role of Blame Attribution in Post-Concussion Syndrome Morbidity: A Retrospective Analysis of Patients at a Subspecialty Clinic" @default.
• W3099282688 doi "https://doi.org/10.1212/01.wnl.0000719976.68053.b6" @default.
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