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Record W2338712344 · doi:10.1177/0706743716644952

Concussion and Psychiatric Outcome in Adults and Children

2016· editorial· en· W2338712344 on OpenAlexvenueno aff
Jeffrey E. Max

Bibliographic record

VenueThe Canadian Journal of Psychiatry · 2016
Typeeditorial
Languageen
FieldMedicine
TopicTraumatic Brain Injury Research
Canadian institutionsnot available
Fundersnot available
KeywordsConcussionTraumatic brain injuryPsychologyChronic traumatic encephalopathyFootballSuicide preventionInjury preventionPsychiatrySports medicinePoison controlMedicinePolitical scienceMedical emergency

Abstract

fetched live from OpenAlex

I accepted the invitation to write this editorial on the traumatic brain injury (TBI) manuscripts in this edition of the Journal because of my career focus on psychiatric aspects of TBI. I disclose that I am also privileged to be a contributing author on both of the TBI articles. The 2 articles that focus on TBI in this edition are review articles of conditions of high public health concern. Public awareness of adult sports-related TBI has risen in the past few years, especially in the arena of football. Therefore, a review of adult sports-related TBI is timely. Similarly, there has been a marked increase in concern regarding mild TBI (mTBI) in children and adolescents, especially in sports (e.g., Institute of Medicine report). Sports capture the imagination of a large segment of society. Adult sports stars tend to become role models for people of all ages, and professional sports are associated with substantial financial implications for players, franchise owners, media, fans, city coffers, and vendors. Thus, when our stars appear to be stricken with psychiatric disorders allegedly from multiple concussions, the sport itself has to respond to investigate the extent and nature of the problem for the safety of participants and the perpetuation of the sport. Concussion in youth has similarly become more prominent in societal discourse. Although pediatric TBI encompasses a much broader problem than sports-related concussion, such is the ubiquity and passion for youth sports in our society that sports have become the driver for public attention to youth TBI. The role of youth sports in society is a positive force for socialization and physical health of our children. Youth sports also involve parents encouraging their children and potentially enhancing parent-child relationships. In addition, parents find that their social networks are extended by socializing with fellow parents of youth team members. The timely question asked is that if adult sport is associated with psychiatric complications from concussion, ‘‘how likely is it that our children who participate in sports face similar risks?’’ The review of psychiatric sequelae of concussion related to adult sports suggested that there is a developing body of evidence supporting the existence of long-term psychiatric and psychological complications. Specifically, in most studies, depressive symptoms were linked to concussion. The studies with regard to anxiety and also substance abuse were few, and findings were mixed with regard to a connection with concussion. Studies that focused on behavioural changes typically identified behaviour and/or cognitive changes after sports concussion, and a link was suggested in 2 studies. Chronic traumatic encephalopathy, a degenerative neurological disease that occurs years after concussion or repetitive head trauma, was included in this review. This broad syndrome is associated with mood, behavior, cognitive, and substance use problems. Clear subtypes and aetiologies have not yet emerged, but there is some evidence of symptom patterns of initial onset of cognitive problems followed by psychiatric complications or early psychiatric problems followed by cognitive decline. The systematic review of psychiatric, psychological, and behavioural outcomes after mTBI in children and adolescents found that problems were more prevalent earlier in the recovery period, when the injury was of sufficient severity to result in hospitalization, where there was preinjury psychiatric disorder, when assessment relied on retrospective recall, and when the comparison group consisted of noninjured healthy children rather than an injured child (e.g., orthopedic fracture) comparison group. There is a clear common characteristic that both these reviews expose. There is a surprising paucity of data on topics that have such a high public health cost and that have generated such public interest and concern. The goldstandard psychiatric assessment, which uses a structured or semistructured psychiatric interview complemented by

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.005
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: none
GenreCandidate signal: Editorial · Consensus signal: none
Teacher disagreement score0.008
Threshold uncertainty score0.017

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0000.005
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0010.001
Science and technology studies0.0010.000
Scholarly communication0.0010.001
Open science0.0000.001
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0030.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.015
GPT teacher head0.312
Teacher spread0.297 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designNot applicable
Domainnot available
GenreEditorial

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations2
Published2016
Admission routes1
Has abstractyes

Explore more

Same venueThe Canadian Journal of Psychiatry→Same topicTraumatic Brain Injury Research→French-language works237,207→